Individual
DAVID STEPHEN PRUDHOME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(903) 597-0351
Mailing address
1000 S BECKHAM AVE, TYLER, TX 75701-1908
(903) 597-0351
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
733431
TX
Other
Enumeration date
12/11/2012
Last updated
06/15/2015
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