MEDICARE: LAURA RHONE P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA04674	TX

General Provider Information

NPI Number	:	1750460135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA RHONE P.A.

Provider Business Mailing Address
First Line	:	4504 BOAT CLUB RD
Second Line	:	SUITE 800
City	:	FORT WORTH
State	:	TX
Zip	:	76135-7003
Country	:	US
Telephone Number	:	817-237-4794
Fax Number	:	817-237-4880

Provider Business Practice Location Address
First Line	:	7630 N BEACH ST
Second Line	:	SUITE 140
City	:	FORT WORTH
State	:	TX
Zip	:	76137-1299
Country	:	US
Telephone Number	:	817-281-2977
Fax Number	:	817-788-2530

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2006
Last Update Date	:	07/08/2007

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Directions to “ LAURA RHONE P.A.” Practice Location

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