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Individual
DR. NESHIA RENAE RUDD
Active
Individual
DR. NESHIA RENAE RUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5643TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00371W
GROUP PTAN
TX
01
—
5634TG
LICENSE
TX
01
—
752948352
TAX ID
TX
Enumeration date
08/16/2006
Last updated
09/27/2022
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