Provider Demographics
NPI:1861100984
Name:TUDMAN, JAI'CEE D (MPAS, PA-C)
Entity type:Individual
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First Name:JAI'CEE
Middle Name:D
Last Name:TUDMAN
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Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:9330 LBJ FWY STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-4310
Mailing Address - Country:US
Mailing Address - Phone:972-792-5700
Mailing Address - Fax:214-506-1170
Practice Address - Street 1:16980 DALLAS PKWY STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1910
Practice Address - Country:US
Practice Address - Phone:972-733-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2023-09-06
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant