MEDICARE: LOUMA BASMA RUSTAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	MD-53111	IA
2	207RG0100X	Gastroenterology Physician	V2251	TX

General Provider Information

NPI Number	:	1164918140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUMA BASMA RUSTAM MD

Provider Business Mailing Address
First Line	:	PO BOX 2758
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50704-2758
Country	:	US
Telephone Number	:	319-235-5390
Fax Number	:

Provider Business Practice Location Address
First Line	:	2240 GULF FWY S STE 2.100
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-5143
Country	:	US
Telephone Number	:	832-505-1600
Fax Number	:	281-309-0419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2018
Last Update Date	:	03/23/2026

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Directions to “ LOUMA BASMA RUSTAM MD” Practice Location

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