Provider Demographics
NPI:1528366333
Name:RUDOW, GALIT VIVIANA (CNM)
Entity Type:Individual
Prefix:MS
First Name:GALIT
Middle Name:VIVIANA
Last Name:RUDOW
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 COMAL ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-4326
Mailing Address - Country:US
Mailing Address - Phone:512-978-9200
Mailing Address - Fax:512-901-9757
Practice Address - Street 1:211 COMAL ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4326
Practice Address - Country:US
Practice Address - Phone:512-978-9200
Practice Address - Fax:512-901-9757
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120032367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife