Provider Demographics
NPI:1578881413
Name:RUSHTON, JENNIFER ROBBIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ROBBIN
Last Name:RUSHTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3445 EXECUTIVE CENTER DRIVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1678
Mailing Address - Country:US
Mailing Address - Phone:512-579-4000
Mailing Address - Fax:512-439-2814
Practice Address - Street 1:3445 EXECUTIVE CENTER DRIVE
Practice Address - Street 2:SUITE 250
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1678
Practice Address - Country:US
Practice Address - Phone:512-579-4000
Practice Address - Fax:512-439-2814
Is Sole Proprietor?:No
Enumeration Date:2010-05-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN0421207ZP0007X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0007XAllopathic & Osteopathic PhysiciansPathologyMolecular Genetic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX217353601Medicaid
TXTXB110602Medicare PIN