Provider Demographics
NPI:1760632731
Name:RHODES, RICHARD GLENN (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:GLENN
Last Name:RHODES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 TEXAS COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4429
Mailing Address - Country:US
Mailing Address - Phone:830-660-6896
Mailing Address - Fax:
Practice Address - Street 1:363 TEXAS COUNTRY DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4429
Practice Address - Country:US
Practice Address - Phone:830-660-6896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22927183500000X
TN6895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist