Provider Demographics
NPI:1225099328
Name:RHODES, ERNESTO P (MD PLLC)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:P
Last Name:RHODES
Suffix:
Gender:M
Credentials:MD PLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 CRESTLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-2723
Mailing Address - Country:US
Mailing Address - Phone:432-620-9001
Mailing Address - Fax:
Practice Address - Street 1:2300 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5843
Practice Address - Country:US
Practice Address - Phone:432-620-9001
Practice Address - Fax:432-620-9003
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3886207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142662901Medicaid
TX202322508OtherTAX ID
TX202322508OtherTAX ID
TX142662901Medicaid