Healthcare Provider Details

I. General information

NPI: 1619382116
Provider Name (Legal Business Name): CAYCE HUNTER TRUDO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2014
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

536 W RANDOL MILL RD
ARLINGTON TX
76011-5738
US

IV. Provider business mailing address

1101 S MAIN ST
FORT WORTH TX
76104-4802
US

V. Phone/Fax

Practice location:
  • Phone: 817-321-4716
  • Fax: 817-548-3997
Mailing address:
  • Phone: 817-321-4716
  • Fax: 817-548-3997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number684173
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: