MEDICARE: MEDICAL CONNECT MEDICAL GROUP TX, P.A.

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	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1396623096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CONNECT MEDICAL GROUP TX, P.A.

Provider Business Mailing Address
First Line	:	254 CHAPMAN RD STE 208
Second Line	:
City	:	NEWARK
State	:	DE
Zip	:	19702-5422
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 N 6TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11249-3075
Country	:	US
Telephone Number	:	844-282-2271
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NATHAN RUCH
Credential	:	MD
Telephone Number	:	844-282-2731

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	08/22/2025

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