Individual
DR. D. RUDOLPH BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4401 MARTIN LUTHER KINGS BLVD, HOUSTON, TX 77204-2020
(713) 743-2020
(713) 743-0963
Mailing address
4401 MARTIN LUTHER KINGS BLVD, HOUSTON, TX 77204-2020
(713) 743-2020
(713) 743-0963
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2311
TX
152W00000X
Optometrist
2311T
TX
152W00000X
Optometrist
2311TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03708501
—
TX
05
—
112409104
—
TX
Enumeration date
05/27/2005
Last updated
05/11/2022
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