Individual
JONATHAN BRYCE RUDOLPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
705 LANDA ST STE B, NEW BRAUNFELS, TX 78130-6163
(210) 360-1590
Mailing address
705 LANDA ST STE B, NEW BRAUNFELS, TX 78130-6163
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
935768
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1190388
TX
Other
Enumeration date
06/26/2024
Last updated
02/06/2025
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