Provider Demographics
NPI:1346242724
Name:NUDD, RICHARD J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:J
Last Name:NUDD
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:9229 LBJ FWY
Mailing Address - Street 2:STE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-3405
Mailing Address - Country:US
Mailing Address - Phone:800-346-0747
Mailing Address - Fax:972-739-2638
Practice Address - Street 1:3100 N TENAYA WAY
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0436
Practice Address - Country:US
Practice Address - Phone:972-915-3600
Practice Address - Fax:972-915-3636
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2019-11-11
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Provider Licenses
StateLicense IDTaxonomies
NVPA830363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVVWCHDG BU811ZMedicare PIN