Provider Demographics
NPI:1972690428
Name:REUL, ROSS M (MD)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:M
Last Name:REUL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1401
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-5200
Mailing Address - Fax:713-793-7428
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1401
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-5200
Practice Address - Fax:713-793-7428
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2017-08-31
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Provider Licenses
StateLicense IDTaxonomies
TXJ7839208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170976803Medicaid
TX170976801Medicaid
TX8FR731OtherBLUE CROSS BLUE SHIELD
TX170976802Medicaid
TX330005962OtherRAILROAD MEDICARE
TX330005962OtherRAILROAD MEDICARE