Provider Demographics
NPI:1639394984
Name:RHODES, ROBBY DOUGLAS (MS,ATC,LAT)
Entity Type:Individual
Prefix:
First Name:ROBBY
Middle Name:DOUGLAS
Last Name:RHODES
Suffix:
Gender:M
Credentials:MS,ATC,LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MESA DR
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-1708
Mailing Address - Country:US
Mailing Address - Phone:806-655-0503
Mailing Address - Fax:
Practice Address - Street 1:60216 WTAMU
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79016-0001
Practice Address - Country:US
Practice Address - Phone:806-651-3640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT17362255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer