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General NPI Number Information
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NPI Number | 1346487972
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Entity Type | Organization
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Legal Business Name | ALEJANDRO D. KUDISCH M.D., PA
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Dates
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Enumeration Date | 01/20/2009
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Last Update Date | 01/30/2009
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Provider Practice Location Address
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Address Line | 110 E SAVANNAH AVE BLDG B -201
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City | MCALLEN
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State | TX
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Zip | 78503-1241
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Country | US
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Telephone | 956-687-3000
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Fax | 956-687-7948
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Provider Business Mailing Address
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Address Line | 110 EAST SAVANNAH BLDG B -201
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City | MCALLEN
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State | TEXAS
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Zip | 78503-1291
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Country | UM
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Telephone | 956-687-3000
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Fax | 956-687-7948
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Authorized Official
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Title or Position | PSYCHISCIAN
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Name | DR. ALEJANDRO D KUDISCH
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Credential | M.D., DFAPA
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Telephone | 956-687-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | J7546
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number | J7546
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | J7546
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License Number State | TX
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