Provider Demographics
NPI:1154453751
Name:MICHAEL A RHODES MD MS PA
Entity Type:Organization
Organization Name:MICHAEL A RHODES MD MS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARYL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-295-6322
Mailing Address - Street 1:1161 SW WILSHIRE BLVD
Mailing Address - Street 2:STE 105
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-5707
Mailing Address - Country:US
Mailing Address - Phone:817-295-6322
Mailing Address - Fax:
Practice Address - Street 1:1161 SW WILSHIRE BLVD
Practice Address - Street 2:STE 105
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-5707
Practice Address - Country:US
Practice Address - Phone:817-295-6322
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4207207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty