MEDICARE: RICHARD T. DUDZINSKI DPM PA

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	555	TX

General Provider Information

NPI Number	:	1962647222
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD T. DUDZINSKI DPM PA

Provider Business Mailing Address
First Line	:	3425 HIGHWAY 6 SOUTH #104
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4439
Country	:	US
Telephone Number	:	281-980-3338
Fax Number	:	281-980-0646

Provider Business Practice Location Address
First Line	:	3425 HIGHWAY 6 SOUTH #104
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-4439
Country	:	US
Telephone Number	:	281-980-3338
Fax Number	:	281-980-0646

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD THOMAS DUDZINSKI
Credential	:	DPM
Telephone Number	:	281-980-3338

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	12/15/2008

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