Provider Demographics
NPI:1346456738
Name:HARGRAVES, RHONDA WEST (FNP)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:WEST
Last Name:HARGRAVES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 BELL ST
Mailing Address - Street 2:STE. 3180
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-7497
Mailing Address - Country:US
Mailing Address - Phone:409-651-3357
Mailing Address - Fax:262-314-3263
Practice Address - Street 1:800 BELL ST
Practice Address - Street 2:STE. 3180
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-7497
Practice Address - Country:US
Practice Address - Phone:409-651-3357
Practice Address - Fax:262-314-3263
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX505519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS61901Medicare UPIN