Provider Demographics
NPI:1619972718
Name:RUDE, KAREN PHILLIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:PHILLIS
Last Name:RUDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1528 COMMON ST
Mailing Address - Street 2:STE 9
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3113
Mailing Address - Country:US
Mailing Address - Phone:830-626-1111
Mailing Address - Fax:
Practice Address - Street 1:1528 COMMON ST
Practice Address - Street 2:STE 9
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3113
Practice Address - Country:US
Practice Address - Phone:830-626-1111
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-08
Deactivation Date:2006-03-17
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
TX21570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist