Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 12146 | TX |
Y | 111NR0400X | Rehabilitation Chiropractor | 12146 | TX |
NPI | 1104123769 |
---|---|
Provider Name | Stuart F Rutledge |
First Address | San Antonio, TX 78232-5052 |
Second Address | Houston, TX 77077-6067 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2011 |
Last Update Date | 08/08/2013 |