Provider Demographics
NPI:1487844130
Name:RHODES, JULIE LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:RHODES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:BARB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3700 CROSS PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-4137
Mailing Address - Country:US
Mailing Address - Phone:979-774-9958
Mailing Address - Fax:979-774-9978
Practice Address - Street 1:3700 CROSS PARK DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-4137
Practice Address - Country:US
Practice Address - Phone:979-774-9958
Practice Address - Fax:979-774-9978
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088441225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L8138Medicare PIN