Provider Demographics
NPI:1982676631
Name:BILES, RHONDA KYLEEN (PA-C)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:KYLEEN
Last Name:BILES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5508 PARKCREST DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4914
Mailing Address - Country:US
Mailing Address - Phone:512-420-9900
Mailing Address - Fax:512-420-9043
Practice Address - Street 1:5508 PARKCREST DR
Practice Address - Street 2:SUITE 310
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4914
Practice Address - Country:US
Practice Address - Phone:512-420-9900
Practice Address - Fax:512-420-9043
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03084363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA03084OtherTX LICENSE
TXPA03084OtherTX LICENSE
TXQ27169Medicare UPIN