MEDICARE: JESSICA NICOLE RHODES

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	172A00000X	Driver	38741488	TX

General Provider Information

NPI Number	:	1114880804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA NICOLE RHODES

Provider Business Mailing Address
First Line	:	4607 CYPRESSWOOD DR APT 1103
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-8358
Country	:	US
Telephone Number	:	346-232-2417
Fax Number	:

Provider Business Practice Location Address
First Line	:	4607 CYPRESSWOOD DR APT 1103
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-8358
Country	:	US
Telephone Number	:	346-232-2417
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ JESSICA NICOLE RHODES ” Practice Location

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