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NPI Code Detail

MEDICARE: DR. ROSALIE PIERCE HUDSON M.D.

MEDICARE: DR. ROSALIE PIERCE HUDSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianL8080TX
2208M00000XHospitalist PhysicianL8080TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1063483873
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSALIE PIERCE HUDSON M.D.
Provider Business Mailing Address
First Line : PO BOX 13442
Second Line :
City : AUSTIN
State : TX
Zip : 78711-3442
Country : US
Telephone Number : 512-350-1781
Fax Number :
Provider Business Practice Location Address
First Line : 901 W BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-6903
Country : US
Telephone Number : 512-350-1781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2006
Last Update Date : 02/20/2020

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