Individual
DR. RICHARD N RUDNICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3330 N GALLOWAY AVE STE 304, MESQUITE, TX 75150-4767
(972) 289-2233
Mailing address
3330 N GALLOWAY AVE STE 304, PMB 91, MESQUITE, TX 75150-4767
(214) 796-9383
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
J2769
TX
207ND0101X
MOHS-Micrographic Surgery Physician
J2769
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0847576-01
—
TX
Enumeration date
12/17/2006
Last updated
02/14/2018
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