Provider Demographics
NPI:1528390986
Name:RHOADES, PAMELA (LAC)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 DUVAL RD
Mailing Address - Street 2:APT. 1116
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3551
Mailing Address - Country:US
Mailing Address - Phone:512-619-2224
Mailing Address - Fax:512-420-8573
Practice Address - Street 1:8701 SHOAL CREEK BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-6864
Practice Address - Country:US
Practice Address - Phone:512-619-2224
Practice Address - Fax:512-420-8573
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist