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General NPI Number Information
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NPI Number | 1497766166
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Entity Type | Individual
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Provider Name | TIMOTHY J RUPP MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 1441 N BECKLEY AVE MMC DALLAS
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City | DALLAS
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State | TX
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Zip | 75203
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Country | US
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Telephone | 214-942-5733
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Fax | 214-942-6115
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Provider Business Mailing Address
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Address Line | 4040 N CENTRAL EXPRESSWAY #600
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City | DALLAS
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State | TX
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Zip | 75204-3147
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Country | US
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Telephone | 214-520-5743
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Fax | 214-520-5786
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 113028
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | M-16868
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License Number State | ID
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 12846217-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C129547
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | K6282
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License Number State | TX
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