Individual
CHARLES HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
CONCORD MEDICAL GROUP, 1602 AVENUE Q, LUBBOCK, TX 79401
(972) 829-6613
(800) 611-5029
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
E-4237
AR
207Q00000X
Family Medicine Physician
Primary
E6429
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131407209
—
TX
05
—
157958001
—
AR
01
—
8DL165
BCBS
TX
01
—
P00204650
RAILROAD MEDICARE
AR
01
—
P01176879
RAILROAD MEDICARE
TX
Enumeration date
10/18/2006
Last updated
05/23/2019
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