NPIMap

Organization Active NPI

Jennifer Hudman, M.D., P.a.

  • Pediatrics Physician
  • Azle, TX
National Provider Identifier
1972886497
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M0759 Issued in TX
Legal business name
JENNIFER HUDMAN, M.D., P.A.
Practice address
604 Southeast Pkwy
Azle, TX 76020-3453
Phone
(817) 270-2320
Fax
(817) 270-2450
NPI assigned
Sep 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Authorized official

Name
Jennifer Hudman, M.D.NPI 1619955432
Title
Physician/Owner
Phone
(817) 270-2320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X M0759 TX Primary

Addresses

Primary practice location

604 Southeast Pkwy
Azle, TX 76020-3453

Mailing address

604 Southeast Pkwy
Azle, TX 76020-3453
Phone (817) 270-2320

Other identifiers 2

IdentifierTypeStateIssuer
175887201MedicaidTX
175887202MedicaidTX

Other names 1

  • Azle Pediatrics Doing business as

National Provider Directory

National Provider Directory

Locations

909 Southeast Pkwy
Ste 101
Azle, TX 76020
Phone (817) 237-9225

604 Southeast Pkwy
Azle, TX 76020
Phone (817) 270-2320

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316563200000",
    "number": "1972886497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SOUTHEAST PKWY",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203453",
            "telephone_number": "817-270-2320",
            "fax_number": "817-270-2450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SOUTHEAST PKWY",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203453",
            "telephone_number": "817-270-2320",
            "fax_number": "817-270-2450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER HUDMAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A",
        "authorized_official_last_name": "HUDMAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "817-270-2320",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M0759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175887201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175887202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Azle Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Azle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.