| Rush Family Health Care, Pa | |
|
5503 N Stateline Ave Texarkana TX 75503-5303 | |
| (903) 794-7874 | |
| (903) 794-0740 |
| Full Name | Rush Family Health Care, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 5503 N Stateline Ave, Texarkana, Texas |
| Authorized Official Name and Position | Ronald David Rush (CEO) |
| Authorized Official Contact | 9037947874 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rush Family Health Care, Pa 5503 N Stateline Ave Texarkana TX 75503-5303 Ph: (903) 794-7874 | Rush Family Health Care, Pa 5503 N Stateline Ave Texarkana TX 75503-5303 Ph: (903) 794-7874 |
| NPI Number | 1609911494 |
|---|---|
| Provider Enumeration Date | 02/20/2007 |
| Last Update Date | 04/25/2008 |
| Medicare PECOS PAC ID | 2567441801 |
|---|---|
| Medicare Enrollment ID | O20160518000961 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609911494 | NPI | - | NPPES |
| 145366002 | Medicaid | AR | |
| 144733601 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | K8971 (Texas) | Primary |
| Provider Name | Mukti Shailesh Parbhoo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528592862 PECOS PAC ID: 4880964782 Enrollment ID: I20201221001691 |
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