Provider Demographics
NPI:1205895612
Name:MUDD, JANICE ANN (DO)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:ANN
Last Name:MUDD
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:12121 RICHMOND AVE
Mailing Address - Street 2:STE 325
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2456
Mailing Address - Country:US
Mailing Address - Phone:281-558-1888
Mailing Address - Fax:281-558-4411
Practice Address - Street 1:12121 RICHMOND AVE
Practice Address - Street 2:STE 325
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2456
Practice Address - Country:US
Practice Address - Phone:281-558-1888
Practice Address - Fax:281-558-4411
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2008-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH3334207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A67434Medicare UPIN
TX80150BMedicare PIN