Provider Demographics
NPI:1366623803
Name:RODDY STROBEL MDPA
Entity Type:Organization
Organization Name:RODDY STROBEL MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODDY
Authorized Official - Middle Name:MARLENE
Authorized Official - Last Name:STROBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-561-5979
Mailing Address - Street 1:3300 S. FM 1788
Mailing Address - Street 2:SUITE 403
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79706
Mailing Address - Country:US
Mailing Address - Phone:432-561-5979
Mailing Address - Fax:432-561-8513
Practice Address - Street 1:3300 S. FM 1788
Practice Address - Street 2:SUITE 403
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79706
Practice Address - Country:US
Practice Address - Phone:432-561-5979
Practice Address - Fax:432-561-8513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0087BXMedicare PIN