Provider Demographics
NPI:1235114927
Name:CUDA, DARRYL D (MD)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:D
Last Name:CUDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8800 VILLAGE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5412
Mailing Address - Country:US
Mailing Address - Phone:210-653-5001
Mailing Address - Fax:210-653-5002
Practice Address - Street 1:8800 VILLAGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5412
Practice Address - Country:US
Practice Address - Phone:210-653-5001
Practice Address - Fax:210-653-5002
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK4402207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030096401Medicaid
TX00339DMedicare PIN
TXG68475Medicare UPIN