Provider Demographics
NPI:1699493510
Name:RODEA, ROSALYNDA (MDS, RD, LD, CCTD)
Entity type:Individual
Prefix:
First Name:ROSALYNDA
Middle Name:
Last Name:RODEA
Suffix:
Gender:F
Credentials:MDS, RD, LD, CCTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6155 ECKHERT RD APT 16201
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-3193
Mailing Address - Country:US
Mailing Address - Phone:956-325-4236
Mailing Address - Fax:
Practice Address - Street 1:6155 ECKHERT RD APT 16201
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3193
Practice Address - Country:US
Practice Address - Phone:956-325-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered