Provider Demographics
NPI:1992519953
Name:VIDACS, JUDIT (PA)
Entity type:Individual
Prefix:
First Name:JUDIT
Middle Name:
Last Name:VIDACS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1860 S ALMA SCHOOL RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-7078
Mailing Address - Country:US
Mailing Address - Phone:480-361-1955
Mailing Address - Fax:480-361-6549
Practice Address - Street 1:1860 S ALMA SCHOOL RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-7078
Practice Address - Country:US
Practice Address - Phone:480-361-1955
Practice Address - Fax:480-361-6549
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ10559363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical