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NPI Code Detail

MEDICARE: DEVON RUSH

MEDICARE: DEVON RUSH
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
1235Z00000XSpeech-Language Pathologist114951TX

General Provider Information

NPI Number : 1811451560
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEVON RUSH
Provider Business Mailing Address
First Line : 4200 SCOTLAND ST APT 137
Second Line :
City : HOUSTON
State : TX
Zip : 77007-7483
Country : US
Telephone Number : 936-212-1168
Fax Number :
Provider Business Practice Location Address
First Line : 1424 FALLBROOK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77038-1846
Country : US
Telephone Number : 346-754-5070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2019
Last Update Date : 01/28/2019

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Directions to “ DEVON RUSH ” Practice Location

Language Start Address Practice Location
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