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NPI Code Detail

MEDICARE: ANGELA RUTHERFORD NP

MEDICARE:   ANGELA  RUTHERFORD  NP
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
1363L00000XNurse Practitioner747951TX

General Provider Information

NPI Number : 1629391016
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA RUTHERFORD NP
Provider Business Mailing Address
First Line : 6410 FANNIN ST STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3014
Country : US
Telephone Number : 713-500-3261
Fax Number : 713-500-3220
Provider Business Practice Location Address
First Line : 6410 FANNIN ST STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3014
Country : US
Telephone Number : 713-500-3261
Fax Number : 713-500-3220
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2010
Last Update Date : 09/29/2022

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Directions to “ ANGELA RUTHERFORD NP” Practice Location

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