Provider Demographics
NPI:1427209014
Name:RHODES, COURTNEY E (OD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:E
Last Name:RHODES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:211 WALTER SEAHOLM DRIVE
Mailing Address - Street 2:UNIT 140
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-3826
Mailing Address - Country:US
Mailing Address - Phone:512-743-5530
Mailing Address - Fax:512-494-4497
Practice Address - Street 1:211 WALTER SEAHOLM DRIVE
Practice Address - Street 2:UNIT 140
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78701-3826
Practice Address - Country:US
Practice Address - Phone:512-472-3937
Practice Address - Fax:512-472-3938
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-01
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX07168TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX07168TGOtherTEXAS OPTOMETRY LICENSE