Provider Demographics
NPI:1558930693
Name:RAPID CITY HEALTHCARE PLLC
Entity Type:Organization
Organization Name:RAPID CITY HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUQ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-952-6048
Mailing Address - Street 1:524 WALES CT
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-5144
Mailing Address - Country:US
Mailing Address - Phone:214-699-7173
Mailing Address - Fax:
Practice Address - Street 1:800 W AIRPORT FWY STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-6206
Practice Address - Country:US
Practice Address - Phone:214-699-7173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-23
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty