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Organization
TIMOTHY J. RUDDELL, M.D., PLLC
Active
Organization
TIMOTHY J. RUDDELL, M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J. RUDDELL M.D. (MANAGER)
(903) 957-1104
Entity
Organization
Contact information
Practice address
600 E TAYLOR ST STE 201, SHERMAN, TX 75090-2832
(903) 957-1104
Mailing address
600 E TAYLOR ST STE 201, SHERMAN, TX 75090-2832
(903) 957-1104
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
P7029
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043466931
INDIVIDUAL NPI
TX
Enumeration date
08/03/2013
Last updated
08/03/2013
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