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NPI Code Detail

MEDICARE: DR. LERIN ELISE RUTHERFORD MD

MEDICARE: DR. LERIN ELISE RUTHERFORD 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
1207L00000XAnesthesiology PhysicianBP10056392TX
2207L00000XAnesthesiology PhysicianS3867TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1649554OTHERTXTEXAS MEDICAL BOARD

General Provider Information

NPI Number : 1508210907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LERIN ELISE RUTHERFORD MD
Provider Business Mailing Address
First Line : 1 BAYLOR PLZ
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3411
Country : US
Telephone Number : 713-798-4951
Fax Number :
Provider Business Practice Location Address
First Line : 6720 BERTNER AVE
Second Line :
City : HOUSTON
State : TX
Zip : 77030-2604
Country : US
Telephone Number : 832-355-2666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 02/06/2026

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