Provider Demographics
NPI:1063483873
Name:HUDSON, ROSALIE PIERCE (MD)
Entity type:Individual
Prefix:DR
First Name:ROSALIE
Middle Name:PIERCE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ROSALIE
Other - Middle Name:CORA
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 13442
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78711-3442
Mailing Address - Country:US
Mailing Address - Phone:512-350-1781
Mailing Address - Fax:
Practice Address - Street 1:901 W BEN WHITE BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6903
Practice Address - Country:US
Practice Address - Phone:512-350-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8080207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168966301Medicaid
TX168966304Medicaid
TX8C6599Medicare PIN