Provider Demographics
NPI:1740560820
Name:RODZIYEVSKA, OLGA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:OLGA
Middle Name:
Last Name:RODZIYEVSKA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6410 FANNIN ST STE 732
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-5202
Mailing Address - Country:US
Mailing Address - Phone:281-935-5917
Mailing Address - Fax:713-500-0530
Practice Address - Street 1:6410 FANNIN ST STE 500
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3005
Practice Address - Country:US
Practice Address - Phone:281-935-5917
Practice Address - Fax:713-500-0530
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01189171100000X
TXPA11844363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No171100000XOther Service ProvidersAcupuncturist