Individual
RENAT KUDYAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7777 FOREST LN STE B446, DALLAS, TX 75230-5647
(972) 566-8822
(972) 566-8861
Mailing address
7777 FOREST LN STE B446, DALLAS, TX 75230-5647
(972) 566-8822
(972) 566-8861
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP137445
TX
363LF0000X
Family Nurse Practitioner
340648
NY
363LF0000X
Family Nurse Practitioner
AP137445
TX
Other
Enumeration date
06/11/2016
Last updated
01/07/2022
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