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Search › Texas › 363L00000X

Renat Kudyakov

NPI 1578912325 · on the registry since 2016

Practice

Address
7777 Forest Ln Ste B446
Dallas, TX 75230
Phone
(972) 566-8822
Fax
(972) 566-8861
Organisation at this address
Proassist
Walgreen Co
Walgreen Co
Repitest Pa
Love Wounds
Inferred from a shared address, not stated in the registry.
Clinicians at this address
672

Additional practice sites

  • 7777 Forest Ln Ste B446, Dallas, TX

Registry record

Primary taxonomy
363L00000X
363L00000X
Also registered as
363LF0000X
363LF0000X
Licence states on file
NY, TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-01-07

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas