Provider Demographics
NPI:1881879054
Name:JUDD, KATHRYN (DO)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:JUDD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9898 COLONNADE BLVD APT 6108
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2271
Mailing Address - Country:US
Mailing Address - Phone:469-525-1949
Mailing Address - Fax:
Practice Address - Street 1:1975 BABCOCK RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4584
Practice Address - Country:US
Practice Address - Phone:214-275-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM-80652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry