Individual
INGRID L UDRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6411 FANNIN ST, HOUSTON, TX 77030-1501
(713) 704-4000
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06152
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203490201
—
TX
01
—
8Y9608
BCBS
TX
Enumeration date
02/11/2009
Last updated
10/07/2009
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