Provider Demographics
NPI:1780756981
Name:SHUDDE, WILLIAM FREDERICK (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:SHUDDE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-3534
Mailing Address - Country:US
Mailing Address - Phone:325-672-3252
Mailing Address - Fax:325-672-3009
Practice Address - Street 1:1441 PINE ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-3534
Practice Address - Country:US
Practice Address - Phone:325-672-3252
Practice Address - Fax:325-672-3009
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2329207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00N69QMedicare PIN
TXF34709Medicare UPIN