Healthcare Provider Details

I. General information

NPI: 1083172860
Provider Name (Legal Business Name): RODRICK HAMMOND NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2019
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MEDICAL CENTER BLVD
WEBSTER TX
77598-4301
US

IV. Provider business mailing address

18333 EGRET BAY BLVD STE 140
HOUSTON TX
77058-3239
US

V. Phone/Fax

Practice location:
  • Phone: 832-224-9500
  • Fax:
Mailing address:
  • Phone: 281-332-3001
  • Fax: 281-332-3005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP140960
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP140960
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: