Provider Demographics
NPI:1831248129
Name:CHUDNOW, ROBERT STEVEN (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:STEVEN
Last Name:CHUDNOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4032 MCDERMOTT RD
Mailing Address - Street 2:SUITE100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-7733
Mailing Address - Country:US
Mailing Address - Phone:972-769-9000
Mailing Address - Fax:972-769-0035
Practice Address - Street 1:4032 MCDERMOTT RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-7733
Practice Address - Country:US
Practice Address - Phone:972-769-9000
Practice Address - Fax:972-769-0035
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2014-06-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ60912084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB52081Medicare UPIN