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General NPI Number Information
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NPI Number | 1386630481
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Entity Type | Individual
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Provider Name | DELBERT C RUDY MD
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Gender | Male
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Dates
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Enumeration Date | 09/23/2005
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Last Update Date | 08/26/2015
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Provider Practice Location Address
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Address Line | 150 RIVER NORTH BLVD
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City | STEPHENVILLE
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State | TX
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Zip | 76401-1803
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Country | US
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Telephone | 254-968-6051
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Fax | 254-968-4950
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Provider Business Mailing Address
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Address Line | 150 RIVER NORTH BLVD
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City | STEPHENVILLE
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State | TX
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Zip | 76401-1803
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Country | US
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Telephone | 254-968-6051
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Fax | 254-968-4950
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G9524
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License Number State | TX
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