Provider Demographics
NPI:1992219042
Name:BUDD, DANTE ANDUHAR BILAL
Entity Type:Individual
Prefix:
First Name:DANTE
Middle Name:ANDUHAR BILAL
Last Name:BUDD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 WATER EDGE POINT LN
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-1903
Mailing Address - Country:US
Mailing Address - Phone:909-587-3119
Mailing Address - Fax:
Practice Address - Street 1:9415 WATER EDGE POINT LN
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-1903
Practice Address - Country:US
Practice Address - Phone:909-587-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician