CHARLES E RUDOLPH (NPI# 1871527135) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871527135 |
| Entity Type | Individual |
| Full Name | CHARLES E RUDOLPH |
| Credential | PHD |
| Practice Address |
3115 Loop 306 Suite 110 San Angelo TX 76904-5983 |
| Practice Telephone | 3259421952 |
| Practice Fax Number | 3259421517 |
| Mailing Telephone | 3259421952 |
| Mailing Fax Number | 3259421517 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-05-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
21568 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS PSHCHSPRING | 87710A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497831267 | Charles John Rudolph Jr. | General Practice | 2800 Kendallwood Parkway, Suite A, Kansas City, MO 64119 | 2006-10-27 |
| 1346351673 | Charles Todd Rudolph | Internal Medicine | 170 Mouse Creek Rd Nw, Cleveland, TN 37312-3840 | 2006-08-31 |
| 1821047853 | Charles Rudolph IIi | Optometrist | 8600 Ward Pkwy, #710, Kansas City, MO 64114-2614 | 2006-05-08 |
| 1386636348 | Charles N Rudolph | Internal Medicine | 4510 Executive Drive, Suite 125, San Diego, CA 92121 | 2005-08-16 |
| Street Address |
3115 LOOP 306 SUITE 110 |
| City | SAN ANGELO |
| State | TX |
| Zip Code | 76904-5983 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689626335 | Jacquelin Wren Greuling | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-05-17 |
| 1780963504 | Peggy A Martinez | Social Worker | 3115 Loop 306, Ste 110, San Angelo, TX 76904-5983 | 2011-08-10 |
| 1902043383 | Karen Marie Parker | Counselor | 3115 Loop 306, Ste110, San Angelo, TX 76904-5983 | 2009-01-07 |
| 1396995452 | Amy L Richardson | Counselor | 3115 Loop 306, Ste. 110, San Angelo, TX 76904-5983 | 2008-09-25 |
| 1699938118 | Tina Ashley | Counselor | 3115 Loop 306, 110, San Angelo, TX 76904-5983 | 2008-07-03 |
| 1487868543 | Psychspring, P.l.l.c. | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2007-05-09 |
| 1396831327 | Johnny Kenneth Burkhalter | Psychologist | 3115 Loop 306, Suite 101, San Angelo, TX 76904 | 2006-10-05 |
| 1720007685 | George David Woodward | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-19 |
| 1073545737 | Richard M Mcgraw | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-06 |
| 1679502835 | Lee L Morrison | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407342702 | Mark Wandal Duncan | Specialist/Technologist | 2237 South Jackson, San Angelo, TX 76904 | 2018-07-10 |
| 1700267259 | Sheila Patterson | Nurse Practitioner | 4251 Sunset Drive, San Angelo, TX 76904 | 2015-06-10 |
| 1346649316 | Mason William Mcclintock | Dentist | 2402 College Hills Blvd. Building 1, Building 1, San Angelo, TX 76904 | 2014-08-15 |
| 1265855712 | Lynn M. Thebo, Lcsw, Pllc | Social Worker | 3109 Southwest Blvd. Ste. B, San Angelo, TX 76904 | 2014-02-03 |
| 1487077459 | Lynn Marie Thebo | Social Worker | 3109 Southwest Blvd., Ste. B, San Angelo, TX 76904 | 2014-01-28 |
| 1558646521 | John Porter Parker Jr. | Pharmacist | 3705 Threewn Trail, San Angelo, TX 76904 | 2011-10-20 |
| 1568772036 | Medical Alliance Group of Texas, LLC | Durable Medical Equipment & Medical Supplies | 2525 S Johnson Ste A, San Angelo, TX 76904 | 2010-10-18 |
| 1578796710 | Jennifer L White | Physical Therapist | 2237 S. Jackson, San Angelo, TX 76904 | 2009-09-03 |
| 1548443203 | Kelly K. Sawyer, D.d.s., P.a. | Dentist | 3013 W. Loop 306, San Angelo, TX 76904 | 2007-12-17 |
| 1023224789 | D&s Residential Services | Intermediate Care Facility, Mentally Retarded | 1706 Idaho Avenue, San Angelo, TX 76904 | 2007-05-16 |
| Find all providers in zip 76904 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558860403 | Melanie Noble | Psychologist | 36 E Twohig Ave Fl 6, San Angelo, TX 76903-6433 | 2018-02-06 |
| 1477607661 | Freddie Eugene Drummond | Psychologist | 1609 S Monroe St, San Angelo, TX 76901-4425 | 2007-01-23 |
| 1497787782 | Carolyn B Reed | Psychologist | 3196 Executive Dr, San Angelo, TX 76904-6802 | 2006-07-07 |
| 1750327649 | Javier Carrillo | Psychologist | 3115 South Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-06-21 |
| 1063467306 | William Atterbury Montgomery | Psychologist | 2501 Dena Dr, San Angelo, TX 76904-5014 | 2006-05-24 |
| 1689626335 | Jacquelin Wren Greuling | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-05-17 |
| 1255974044 | Charles Zapata | Psychologist | 271 Fort Richardson Ave, San Angelo, TX 76908-4901 | 2019-10-24 |
| 1992178396 | M & M Counseling & Assessment Services, P.a. | Psychologist | 2501 Dena Dr, San Angelo, TX 76904-5014 | 2015-11-06 |
| 1548692502 | Nizhoni Behavioral Health Center | Psychologist | 3814 Sherwood Way, San Angelo, TX 76901-3539 | 2013-08-01 |
| 1720007685 | George David Woodward | Psychologist | 3115 Loop 306, Suite 110, San Angelo, TX 76904-5983 | 2006-07-19 |
| Find all providers in SAN ANGELO | ||||
| City | SAN ANGELO |
| Zip Code | 76904 |
Please comment or provide details below to improve the information on CHARLES E RUDOLPH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.