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General NPI Number Information
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NPI Number | 1518092519
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Entity Type | Organization
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Legal Business Name | JOHN F. PRUDICH, M. D., P. A.
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1441 N REDBUD BLVD SUITE 121
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City | MCKINNEY
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State | TX
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Zip | 75069-3224
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Country | US
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Telephone | 972-562-5800
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Fax | 972-562-2240
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Provider Business Mailing Address
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Address Line | 1441 N REDBUD BLVD SUITE 121
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City | MCKINNEY
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State | TX
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Zip | 75069-3224
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Country | US
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Telephone | 972-562-5800
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Fax | 972-562-2240
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN FRANCIS PRUDICH
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Credential | M. D.
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Telephone | 972-562-5800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G3706
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License Number State | TX
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