Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 1175915 | TX |
NPI | 1033716782 |
---|---|
Provider Name | Lauren Rudie |
First Address | Friendswood, TX 77546-7873 |
Second Address | Pearland, TX 77584-2153 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2020 |
Last Update Date | 06/10/2020 |