Rurak, Jackie (Jack) Duwayne

Rurak, Jackie (Jack) Duwayne is an individual health care provider with primary practice located at 604 N Nolan River Rd , Cleburne TX 76033-7008. He recently has only one registered license in Technologists, Technicians & Other Technical Service Providers / Technician, Other, which is considered as his primary health care specialty. Rurak, Jackie (Jack) Duwayne can be contacted via phone (817) 645-4718.

Contact Information

Primary practice address
604 N Nolan River Rd Cleburne TX 76033-7008
Phone: (817) 645-4718
Fax: (817) 641-2960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Technologists, Technicians & Other Technical Service Providers / Technician, Other 247200000X Texas

Profile Details

NPI number 1730502279
LBN Legal business name Rurak, Jackie (Jack) Duwayne
Credentials ATP #64040
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2014
Last updated Feb 3rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730502279 NPPES
Texas MEDICAID 015900601

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