Provider Demographics
NPI:1528162153
Name:RUX, HAROLD WAYNE (DDS)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:WAYNE
Last Name:RUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2422 RANCH ROAD 620 S
Mailing Address - Street 2:SUITE A126
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5604
Mailing Address - Country:US
Mailing Address - Phone:512-263-8989
Mailing Address - Fax:512-263-9095
Practice Address - Street 1:2422 RANCH ROAD 620 S
Practice Address - Street 2:SUITE A126
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78738-5604
Practice Address - Country:US
Practice Address - Phone:512-263-8989
Practice Address - Fax:512-263-9095
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0900151-02Medicaid