Organization
SAMUEL L HUDSON MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAMILLE HUDSON (MANAGER)
(979) 299-6900
Entity
Organization
Contact information
Practice address
120 FLAG LAKE DR, LAKE JACKSON, TX 77566-6292
(979) 299-6900
(979) 299-6903
Mailing address
PO BOX 4165, LAKE JACKSON, TX 77566-2065
(979) 299-6900
(979) 299-6903
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
F4099
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183692601
—
TX
Enumeration date
06/05/2009
Last updated
06/05/2009
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