Provider Demographics
NPI:1619087855
Name:DELOACHE, RHONDA K (DC)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:K
Last Name:DELOACHE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 WAUGH DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3907
Mailing Address - Country:US
Mailing Address - Phone:713-521-2003
Mailing Address - Fax:713-521-2057
Practice Address - Street 1:1305 WAUGH DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-3907
Practice Address - Country:US
Practice Address - Phone:713-521-2003
Practice Address - Fax:713-521-2057
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT12955Medicare UPIN