Provider Demographics
NPI:1811128051
Name:HUNTER, RODERICK CECIL JR (DPM)
Entity type:Individual
Prefix:DR
First Name:RODERICK
Middle Name:CECIL
Last Name:HUNTER
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 COIT RD STE 209
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-6172
Mailing Address - Country:US
Mailing Address - Phone:972-877-3939
Mailing Address - Fax:972-767-3584
Practice Address - Street 1:1600 COIT RD STE 209
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-877-3939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-05
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT30-2009213ES0103X
TX2015213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX315622601Medicaid
8DL780OtherBCBSTX
9836906OtherAETNA
200864279OtherTRICARE
TX266416YM41Medicare PIN