MEDICARE: RICE MEDICAL ASSOCITATION

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1467479055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICE MEDICAL ASSOCITATION

Provider Business Mailing Address
First Line	:	610 S AUSTIN RD
Second Line	:
City	:	EAGLE LAKE
State	:	TX
Zip	:	77434-3202
Country	:	US
Telephone Number	:	979-234-2551
Fax Number	:

Provider Business Practice Location Address
First Line	:	610 S AUSTIN RD
Second Line	:
City	:	EAGLE LAKE
State	:	TX
Zip	:	77434-3202
Country	:	US
Telephone Number	:	979-234-2551
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. CINDY BOEGER
Credential	:
Telephone Number	:	979-234-2551

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	08/22/2020

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1851591416 — RICE DISTRICT COMMUNITY HOSPITAL
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Directions to “RICE MEDICAL ASSOCITATION ” Practice Location

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