Malcolm Rude, M.D., P.a.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

K9893 Issued in TX

Legal business name

MALCOLM RUDE, M.D., P.A.

Practice address

2809 Earl Rudder Fwy S
Ste 101
College Station, TX 77845-6080

Phone

(979) 776-8825

Fax

(979) 776-2655

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Malcolm Joe Rude, M.D.NPI 1306841994

Title

Owner/Physician

Phone

(979) 776-8825

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Malcolm J Rude, M. D.

  • Plastic Surgery Physician
  • College Station, TX
  • NPI 1306841994
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713830400000",
    "number": "1184806044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 EARL RUDDER FWY S",
            "address_2": "STE 101",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456080",
            "telephone_number": "979-776-8825",
            "fax_number": "979-776-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 EARL RUDDER FWY S",
            "address_2": "STE 101",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778456080",
            "telephone_number": "979-776-8825",
            "fax_number": "979-776-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALCOLM RUDE, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A",
        "authorized_official_last_name": "RUDE",
        "authorized_official_first_name": "MALCOLM",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "979-776-8825",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "K9893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "8B8743",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0046LN",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166208201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Plastic Surgery Physician in College Station, TX
• Providers in College Station, TX by specialty
• Plastic Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.