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Contact Information

RENAT KUDYAKOV
7777 FOREST LN STE B446
DALLAS, TX75230-5647
 Phone: 972-566-8822
 Fax: 972-566-8861
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for RENAT KUDYAKOV · (Male)

NPI Number 1578912325
Status Active
Credentials
Entity Individual
Enumeration date 06/11/2016
Last updated 01/07/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 340648
  • TX License # AP137445
Hospital affiliation(s)
  • MEDICAL CITY DALLAS HOSPITAL - (Acute Care)
    7777 FOREST LANE
    DALLAS, TX 75230
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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