Healthcare Provider Details

I. General information

NPI: 1235114927
Provider Name (Legal Business Name): DARRYL D CUDA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 11/15/2024
Certification Date: 11/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 OAKWELL FARMS PKWY STE 125
SAN ANTONIO TX
78218-1720
US

IV. Provider business mailing address

1919 OAKWELL FARMS PKWY STE 125
SAN ANTONIO TX
78218-1720
US

V. Phone/Fax

Practice location:
  • Phone: 210-653-5001
  • Fax: 210-653-5002
Mailing address:
  • Phone: 210-653-5001
  • Fax: 210-653-5002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberK4402
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: