Provider Demographics
NPI:1508835471
Name:RUE, BRADLEY C (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:C
Last Name:RUE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:600 E TAYLOR ST
Mailing Address - Street 2:STE 305
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-2833
Mailing Address - Country:US
Mailing Address - Phone:903-957-0060
Mailing Address - Fax:903-957-0059
Practice Address - Street 1:600 E TAYLOR ST
Practice Address - Street 2:STE 305
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-2833
Practice Address - Country:US
Practice Address - Phone:903-957-0060
Practice Address - Fax:903-957-0059
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL1725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145951303Medicaid
P00284032OtherRAILROAD MEDICARE
P00284032OtherRAILROAD MEDICARE
TX145951303Medicaid