Provider Demographics
NPI:1427153568
Name:RHOAD, DEIRDRE M (MD)
Entity type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:M
Last Name:RHOAD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:11671 JOLLYVILLE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4141
Mailing Address - Country:US
Mailing Address - Phone:512-476-9149
Mailing Address - Fax:512-476-8654
Practice Address - Street 1:11671 JOLLYVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4141
Practice Address - Country:US
Practice Address - Phone:512-476-9149
Practice Address - Fax:512-476-8654
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2021-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH4642208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF63637Medicare UPIN