Provider Demographics
NPI:1124089412
Name:RUUD, CHRISTOPHER OWEN (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:OWEN
Last Name:RUUD
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:
Practice Address - Street 1:901 W 38TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1165
Practice Address - Country:US
Practice Address - Phone:512-421-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF5732207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPO1279577OtherRAILROAD MEDICARE
TX137861420Medicaid
TX137861417Medicaid
TX830008565OtherRR/MEDICARE
TX1378614-14OtherCSHCN
TX137861421Medicaid
TX8G5397OtherBLUE SHIELD
TXP01279580OtherRAILROAD MEDICARE
TX137861421Medicaid
TXPO1279577OtherRAILROAD MEDICARE
TX321385YKYCMedicare PIN
TX272045YN56Medicare PIN
TXC21400Medicare UPIN