Provider Demographics
NPI:1952561870
Name:RUDA, FRANK J (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:J
Last Name:RUDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17450 ST LUKES WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8045
Mailing Address - Country:US
Mailing Address - Phone:281-363-3443
Mailing Address - Fax:936-271-1351
Practice Address - Street 1:17450 ST LUKES WAY STE 100
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8045
Practice Address - Country:US
Practice Address - Phone:281-363-3443
Practice Address - Fax:936-271-1351
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0693207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX338825808Medicaid
TX361062YM37OtherMEDICARE TEXAS
TX338825807Medicaid
TX338825809Medicaid
TX361062YVNKOtherMEDICARE TEXAS
TX338825809Medicaid
TX361062YT4LMedicare PIN
TX338825807Medicaid