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Individual
MARIO RUDY ANZALDUA
Active
Individual
MARIO RUDY ANZALDUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
F9142
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127155301
—
TX
01
—
127155304
THSTEPS MEDICAID
TX
01
—
176830600
US DEPARTMENT OF LABOR / W/C
TX
Enumeration date
06/19/2006
Last updated
10/19/2022
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