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General NPI Number Information
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NPI Number | 1598753535
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Entity Type | Individual
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Provider Name | JUDY G PERDUE NP
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Gender | Female
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 11/14/2016
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Provider Practice Location Address
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Address Line | 2510 E MAIN ST SUITE 106
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City | ALICE
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State | TX
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Zip | 78332-4187
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Country | US
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Telephone | 361-661-8370
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Fax | 361-661-8375
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Provider Business Mailing Address
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Address Line | 919 HIDDEN RDG
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City | IRVING
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State | TX
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Zip | 75038-3813
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Country | US
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Telephone | 469-282-2711
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Fax | 469-282-0996
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | AP108623
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License Number State | TX
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