Individual provider Active NPI

Lane Dudo, FNP-C

  • Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1164994430
Registry record updated Nov 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP139752 Issued in TX
Practice address
910 E Houston St Ste 100
Tyler, TX 75702-8363
Phone
(903) 606-8718
Fax
(903) 606-1218
NPI assigned
Dec 26, 2018
Last updated
Nov 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP139752 TX Primary

Addresses

Primary practice location

910 E Houston St Ste 100
Tyler, TX 75702-8363

Mailing address

910 E Houston St Ste 100
Tyler, TX 75702-8363
Phone (903) 606-8718

Other identifiers 4

IdentifierTypeStateIssuer
930848OtherTXMEDICARE
P02416489OtherTXMEDICARE RAIL ROAD
395024803MedicaidTX
8LY464OtherTXBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190122003491 TX Practitioner - Nurse Practitioner 7618214149 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

910 E Houston St
550 Christus Trinity Clinic
Tyler, TX 75702-8366
Phone (903) 510-8718

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Dec 1, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Feb 17, 2020 Accepting new patients
Etmc Physician Group Inc. CurrentSince Dec 1, 2018 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Feb 17, 2020 Accepting new patients
Starks Medical Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

6210 S Broadway Ave
Tyler, TX 75703
Phone (903) 579-2700

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

910 E Houston St
Ste 100
Tyler, TX 75702
Phone (903) 606-8718

910 E Houston St
Ste 550
Tyler, TX 75702
Phone (903) 510-8718

Interoperability endpoints

  • Direct secure messaging: pdudo23554@christushealth.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762992000000",
    "number": "1164994430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E HOUSTON ST STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028363",
            "telephone_number": "903-606-8718",
            "fax_number": "903-606-1218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E HOUSTON ST STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028363",
            "telephone_number": "903-606-8718",
            "fax_number": "903-606-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDO",
        "first_name": "LANE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2025-11-13",
        "certification_date": "2025-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP139752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "930848",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAIL ROAD",
            "identifier": "P02416489",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "395024803",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8LY464",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.