Provider Demographics
NPI:1972367134
Name:HUDSON, ELIZABETH MALVEAUX
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MALVEAUX
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7109 SALEM CT
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75089-3968
Mailing Address - Country:US
Mailing Address - Phone:214-448-7604
Mailing Address - Fax:
Practice Address - Street 1:439 MASON PARK BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6241
Practice Address - Country:US
Practice Address - Phone:214-448-7604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities