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General NPI Number Information
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NPI Number | 1801084181
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Entity Type | Organization
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Legal Business Name | RUFUS GREEN MD PA
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 09/26/2008
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Provider Practice Location Address
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Address Line | 9 MEDICAL PKWY PLAZA 4 307
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City | DALLAS
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State | TX
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Zip | 75234-7855
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Country | US
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Telephone | 972-243-3368
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Fax | 972-243-5296
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Provider Business Mailing Address
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Address Line | 9 MEDICAL PKWY PLAZA 4 STE 307
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City | DALLAS
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State | TX
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Zip | 75234-7855
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Country | US
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Telephone | 972-243-3368
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Fax | 972-243-5296
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROSE ANN FOLEY
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Credential |
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Telephone | 972-243-3368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | H5889
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License Number State | TX
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