Provider Demographics
NPI:1205056116
Name:BUDRICH, EVETTE (MD)
Entity type:Individual
Prefix:DR
First Name:EVETTE
Middle Name:
Last Name:BUDRICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 NW 120TH CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1729
Mailing Address - Country:US
Mailing Address - Phone:405-773-0442
Mailing Address - Fax:405-773-0446
Practice Address - Street 1:6006 NW 120TH CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1729
Practice Address - Country:US
Practice Address - Phone:405-773-0442
Practice Address - Fax:405-773-0446
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK19477207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics