Provider Demographics
NPI:1922338714
Name:LIGE B. RUSHING,JR.,M.D.,P.A.
Entity Type:Organization
Organization Name:LIGE B. RUSHING,JR.,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:LIGE
Authorized Official - Middle Name:BURROUGHS
Authorized Official - Last Name:RUSHING
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:214-368-3611
Mailing Address - Street 1:8210 WALNUT HILL LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4405
Mailing Address - Country:US
Mailing Address - Phone:214-368-3611
Mailing Address - Fax:214-696-3695
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 120
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-368-3611
Practice Address - Fax:214-696-3695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2010-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD67697Medicare UPIN