Provider Demographics
NPI:1023053311
Name:RHODORA U. OSTREA, M.D., P.A.
Entity type:Organization
Organization Name:RHODORA U. OSTREA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-591-7900
Mailing Address - Street 1:2625 SCRIPTURE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2302
Mailing Address - Country:US
Mailing Address - Phone:940-591-7900
Mailing Address - Fax:940-591-7997
Practice Address - Street 1:2625 SCRIPTURE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2302
Practice Address - Country:US
Practice Address - Phone:940-591-7900
Practice Address - Fax:940-591-7997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG82446Medicare UPIN
8D1301Medicare PIN