Individual
JASON LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-3503
(409) 772-0642
(409) 747-0777
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-0435
(409) 772-0644
(409) 747-0777
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
BP10089921
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Enumeration date
06/01/2021
Last updated
07/28/2024
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