Provider Demographics
NPI:1437516333
Name:RHODES, STELLA
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:STELLA
Other - Middle Name:K
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6520 FRATT RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-4402
Mailing Address - Country:US
Mailing Address - Phone:210-938-4536
Mailing Address - Fax:210-938-4503
Practice Address - Street 1:6520 FRATT RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-4402
Practice Address - Country:US
Practice Address - Phone:210-938-4536
Practice Address - Fax:210-938-4503
Is Sole Proprietor?:No
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21117183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist