Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | F8656 | TX |
N | 111NI0900X | Internist | F8656 | TX |
N | 207RA0401X | Internist - Addiction Medicine | F8656 | TX |
NPI | 1922066620 |
---|---|
Provider Name | Dr. Terry A Rustin |
First Address | Houston, TX 77002-8646 |
Second Address | Houston, TX 77002-8646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 12/10/2011 |