Provider Demographics
NPI:1255317079
Name:PONDT, ROCHELLE E (DO)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:E
Last Name:PONDT
Suffix:
Gender:F
Credentials:DO
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 90190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77290-0190
Mailing Address - Country:US
Mailing Address - Phone:281-587-1700
Mailing Address - Fax:281-880-6977
Practice Address - Street 1:1200 BINZ ST STE 1240
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-6927
Practice Address - Country:US
Practice Address - Phone:713-923-5432
Practice Address - Fax:662-499-2366
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-22
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CJ772OtherBCBS #
TX8CJ772OtherBCBS #