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NPI Code Detail

MEDICARE: DR. MALCOLM J RUDE M. D.

MEDICARE: DR. MALCOLM J RUDE M. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208200000XPlastic Surgery PhysicianK9893TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20046LNOTHERTXBCBS

General Provider Information

NPI Number : 1306841994
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MALCOLM J RUDE M. D.
Provider Business Mailing Address
First Line : 2809 EARL RUDDERY FWY S
Second Line : STE 101
City : COLLEGE STATION
State : TX
Zip : 77845-6080
Country : US
Telephone Number : 979-776-8825
Fax Number : 979-776-2655
Provider Business Practice Location Address
First Line : 2809 EARL RUDDERY FWY S
Second Line : STE 101
City : COLLEGE STATION
State : TX
Zip : 77845-6080
Country : US
Telephone Number : 979-776-8825
Fax Number : 979-776-2655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 04/23/2024

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Directions to “ DR. MALCOLM J RUDE M. D.” Practice Location

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