Provider Demographics
NPI:1124022868
Name:ROLNICK, RICHARD HAROLD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HAROLD
Last Name:ROLNICK
Suffix:
Gender:M
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:PO BOX 710330
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77271-0330
Mailing Address - Country:US
Mailing Address - Phone:713-744-2000
Mailing Address - Fax:713-744-2001
Practice Address - Street 1:10910 S GESSNER RD
Practice Address - Street 2:BOX 710330
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3504
Practice Address - Country:US
Practice Address - Phone:713-744-2000
Practice Address - Fax:713-744-2001
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2021-10-13
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
TX174400000X
TXG7769208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX035509101Medicaid
TX035509101Medicaid
TX035509101Medicaid