Provider Demographics
NPI:1356377907
Name:ASHWORTH, RODNEY BRIAN (MD)
Entity type:Individual
Prefix:
First Name:RODNEY
Middle Name:BRIAN
Last Name:ASHWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 RENFERT WAY
Mailing Address - Street 2:SUITE 335
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-5354
Mailing Address - Country:US
Mailing Address - Phone:512-836-3210
Mailing Address - Fax:512-339-8203
Practice Address - Street 1:12201 RENFERT WAY
Practice Address - Street 2:SUITE 335
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5354
Practice Address - Country:US
Practice Address - Phone:512-836-3210
Practice Address - Fax:512-339-8203
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH7872208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0381436-02Medicaid
TX8F0310Medicare UPIN
TX0381436-02Medicaid