1881845477 NPI number — RHODES VISION LLC

Table of content: (NPI 1881845477)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881845477 NPI number — RHODES VISION LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RHODES VISION LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881845477
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/12/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 WALTER SEAHOLM DRIVE
Provider Second Line Business Mailing Address:
UNIT 140
Provider Business Mailing Address City Name:
AUSTIN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78701-3826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-743-5530
Provider Business Mailing Address Fax Number:
512-494-4497

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 WALTER SEAHOLM DRIVE
Provider Second Line Business Practice Location Address:
UNIT 140
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78701-3826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-743-5530
Provider Business Practice Location Address Fax Number:
512-494-4497
Provider Enumeration Date:
10/01/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RHODES
Authorized Official First Name:
COURTNEY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
DOCTOR OF OPTOMETRY
Authorized Official Telephone Number:
512-743-5530

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  07168TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0073RN . This is a "BCBS OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 07168TG . This is a "TEXAS OPTOMETRY LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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