Provider Demographics
NPI:1225660202
Name:NIPP, RHONDA KATHERINE (PT)
Entity type:Individual
Prefix:
First Name:RHONDA
Middle Name:KATHERINE
Last Name:NIPP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7128 BUNK HOUSE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-2530
Mailing Address - Country:US
Mailing Address - Phone:817-455-3266
Mailing Address - Fax:
Practice Address - Street 1:1207 S WHITE CHAPEL BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9316
Practice Address - Country:US
Practice Address - Phone:817-455-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1150901225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist