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General NPI Number Information
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NPI Number | 1922634724
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Entity Type | Individual
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Provider Name | CARRA DUDLEY PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 415 E PARKWOOD AVE
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-5149
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Country | US
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Telephone | 281-648-4250
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Fax |
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Provider Business Mailing Address
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Address Line | 2113 SEDONA DR
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City | LEAGUE CITY
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State | TX
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Zip | 77573-1566
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Country | US
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Telephone |
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Fax |
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1309138
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 1309138
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License Number State | TX
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