Provider Demographics
NPI:1023790367
Name:RHIAN, RHODA
Entity type:Individual
Prefix:MISS
First Name:RHODA
Middle Name:
Last Name:RHIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15150 PRESTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4871
Mailing Address - Country:US
Mailing Address - Phone:424-430-5025
Mailing Address - Fax:620-634-0990
Practice Address - Street 1:15150 PRESTON RD STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4871
Practice Address - Country:US
Practice Address - Phone:424-430-5025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2024-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030390363LP0808X
TX1070072363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health