Provider Demographics
NPI:1730249160
Name:RUDOLPH, BILL ARTHUR JR (MA)
Entity type:Individual
Prefix:MR
First Name:BILL
Middle Name:ARTHUR
Last Name:RUDOLPH
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 E MANCHACA
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1680
Mailing Address - Country:US
Mailing Address - Phone:512-444-8684
Mailing Address - Fax:512-444-8697
Practice Address - Street 1:4403 E MANCHACA
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1680
Practice Address - Country:US
Practice Address - Phone:512-444-8684
Practice Address - Fax:512-444-8697
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50378231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX514099OtherBCBS