Provider Demographics
NPI:1609183953
Name:BIRUNGI, JUDITH (MD)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:
Last Name:BIRUNGI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 W 5TH ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ODESA
Mailing Address - State:TX
Mailing Address - Zip Code:79761
Mailing Address - Country:US
Mailing Address - Phone:432-580-0300
Mailing Address - Fax:432-580-0306
Practice Address - Street 1:540 W 5TH ST STE 400
Practice Address - Street 2:
Practice Address - City:ODESA
Practice Address - State:TX
Practice Address - Zip Code:79761
Practice Address - Country:US
Practice Address - Phone:432-580-0300
Practice Address - Fax:432-580-0306
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-08
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9297208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program