Healthcare Provider Details

I. General information

NPI: 1720099013
Provider Name (Legal Business Name): RODERICK PETER DIGGS III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GARTH RD STE 212
BAYTOWN TX
77521-3158
US

IV. Provider business mailing address

4301 GARTH RD STE 212
BAYTOWN TX
77521-3158
US

V. Phone/Fax

Practice location:
  • Phone: 281-886-7566
  • Fax: 281-520-3515
Mailing address:
  • Phone: 281-886-7566
  • Fax: 281-520-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberK7143
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: