Basic Information
| Provider Information | |||||||||
| NPI: | 1356804496 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RHODES | ||||||||
| FirstName: | DUSTIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5656 KELLEY ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770261967 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7135665000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5211 FM 2920 RD STE 101 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773883004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2817838162 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2019 | ||||||||
| LastUpdateDate: | 07/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP142555 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | AP142555 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.