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General NPI Number Information
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NPI Number | 1306841994
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Entity Type | Individual
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Provider Name | MALCOLM J RUDE M. D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2005
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 2809 EARL RUDDERY FWY S STE 101
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City | COLLEGE STATION
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State | TX
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Zip | 77845-6080
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Country | US
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Telephone | 979-776-8825
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Fax | 979-776-2655
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Provider Business Mailing Address
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Address Line | 2809 EARL RUDDERY FWY S STE 101
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City | COLLEGE STATION
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State | TX
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Zip | 77845-6080
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Country | US
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Telephone | 979-776-8825
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Fax | 979-776-2655
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | K9893
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License Number State | TX
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