Individual
DR. JEROME J. HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 WESTBANK DRIVE, SUITE 100, AUSTIN, TX 78746
(512) 610-6919
(512) 610-6927
Mailing address
925 WESTBANK DRIVE, SUITE 100, AUSTIN, TX 78746
(512) 610-6919
(512) 610-6927
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E2628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-0651861
TAX IDENTIFICATION NUMBER
TX
01
—
E2628
STATE MEDICAL LICENSE
TX
01
—
H0032565
TX DPS
TX
Enumeration date
08/11/2006
Last updated
03/07/2023
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