Provider Demographics
NPI:1629131941
Name:RHODES, ROXANA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROXANA
Middle Name:A
Last Name:RHODES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1250
Mailing Address - Country:US
Mailing Address - Phone:512-453-3542
Mailing Address - Fax:512-453-3555
Practice Address - Street 1:631 W 38TH ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1250
Practice Address - Country:US
Practice Address - Phone:512-453-3542
Practice Address - Fax:512-453-3555
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82Z141OtherBCBS PROVIDER
TXJ3375OtherTEXAS MEDICAL LICENSE
TXG09611Medicare UPIN
TXJ3375OtherTEXAS MEDICAL LICENSE