Provider Demographics
NPI:1043215551
Name:CAUDLE, JUDITH ANN (AUD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:CAUDLE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 LILLIAN MILLER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-7214
Mailing Address - Country:US
Mailing Address - Phone:940-387-0550
Mailing Address - Fax:940-387-0663
Practice Address - Street 1:2540 LILLIAN MILLER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7214
Practice Address - Country:US
Practice Address - Phone:940-387-0550
Practice Address - Fax:940-387-0663
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50788231H00000X
TX90409237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086951301Medicaid
R70330Medicare UPIN
TX086951301Medicaid