MEDICARE: DR. STEVEN JEFFREY HUDAK 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
1	208800000X	Urology Physician	23612	NE
2	208800000X	Urology Physician	N5116	TX

General Provider Information

NPI Number	:	1992760045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN JEFFREY HUDAK M.D.

Provider Business Mailing Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:	MCHE-SDU, BUILDING 3600
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-6200
Country	:	US
Telephone Number	:	210-916-1163
Fax Number	:	210-916-5076

Provider Business Practice Location Address
First Line	:	3551 ROGER BROOKE DR
Second Line	:	MCHE-SDU, BUILDING 3600
City	:	SAN ANTONIO
State	:	TX
Zip	:	78234-6200
Country	:	US
Telephone Number	:	210-916-1163
Fax Number	:	210-916-5076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	08/13/2012

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Directions to “ DR. STEVEN JEFFREY HUDAK M.D.” Practice Location

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