Individual
M'LISS A HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
802 MEDICAL DR, SUITE 400, LONGVIEW, TX 75605-5100
(903) 757-7871
(903) 753-2479
Mailing address
PO BOX 847176, DALLAS, TX 75284-7176
(903) 237-1800
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G3482
TX
208800000X
Urology Physician
MD.205535
LA
208800000X
Urology Physician
R8H73
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02005302
—
MS
05
—
123023705
—
TX
05
—
2307941
—
LA
Enumeration date
12/14/2006
Last updated
03/30/2021
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