Marc L Kudisch MD PA

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

J1289 Issued in TX

Legal business name

MARC L KUDISCH MD PA

Practice address

6699 Chimney Rock Rd
Suite 103
Houston, TX 77081-5358

Phone

(713) 777-9995

Fax

(713) 777-0100

NPI assigned

Dec 22, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Marc L Kudisch, MD

Title

President

Phone

(713) 777-9995

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301788800000",
    "number": "1043514672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 CHIMNEY ROCK RD",
            "address_2": "SUITE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770815358",
            "telephone_number": "713-777-9995",
            "fax_number": "713-777-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6699 CHIMNEY ROCK RD",
            "address_2": "SUITE 103",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770815358",
            "telephone_number": "713-777-9995",
            "fax_number": "713-777-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARC L KUDISCH MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-22",
        "last_updated": "2011-04-03",
        "status": "A",
        "authorized_official_last_name": "KUDISCH",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-777-9995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "J1289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131866903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.