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Organization
JOHN A. RUDIS, MD,PA
Active
Organization
JOHN A. RUDIS, MD,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RUDIS MD (MEDICAL DOCTOR)
(936) 637-6502
Entity
Organization
Contact information
Practice address
206 GENE SAMFORD DR, SUITE A, LUFKIN, TX 75904-3358
(936) 637-7667
(936) 637-2363
Mailing address
206 GENE SAMFORD DR, SUITE A, LUFKIN, TX 75904-3358
(936) 637-7667
(936) 637-2363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H2745
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00B42U
MEDICARE
TX
05
—
120513003
—
TX
Enumeration date
05/27/2011
Last updated
05/27/2011
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