Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | TRN21451 | FL |
N | 207XS0117X | Orthopaedic Spine Surgeon | 035.151828 | IL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | T1538 | TX |
NPI | 1255726444 |
---|---|
Provider Name | Dr. Augustus John Rush III |
First Address | Dallas, TX 75243-3788 |
Second Address | Dallas, TX 75243-3788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2015 |
Last Update Date | 24/07/2021 |