Provider Demographics
NPI:1972722064
Name:CADORE, JUDITH MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MARTIN
Last Name:CADORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:STE 1200W
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:972-720-7820
Mailing Address - Fax:214-775-4502
Practice Address - Street 1:125 E 8TH ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-2753
Practice Address - Country:US
Practice Address - Phone:281-930-8555
Practice Address - Fax:281-930-9870
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5553207Q00000X, 207QA0401X, 207QA0505X, 207QG0300X, 207QS0010X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001030Medicare ID - Type UnspecifiedMEDICARE NUMBER
TXF77338Medicare UPIN
TX10028799OtherAETNA (PPO)
TX70088356OtherDPS
TX137788909Medicaid
TX0024GQOtherBLUECROSS BLUESHIELD
TX18009908247OtherTCHIP
TXA002OtherTRICARE-CHAMPUS
TX137788909OtherTPI
TXP000163QGOtherNHIC
TX760488120OtherHUMANA
TX2561008OtherAETNA (HMO)