Provider Demographics
NPI:1962484832
Name:DEL GIUDICE, JOSE A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:A
Last Name:DEL GIUDICE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54088
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-4088
Mailing Address - Country:US
Mailing Address - Phone:806-771-2400
Mailing Address - Fax:806-771-7760
Practice Address - Street 1:5220 80TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-2862
Practice Address - Country:US
Practice Address - Phone:806-771-2400
Practice Address - Fax:806-771-7760
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3710207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8445N2OtherBCBS
TXF80007Medicare UPIN
TX8445N2OtherBCBS
00680RMedicare ID - Type UnspecifiedMEDICARE GROUP #