MEDICARE: DR. RHONDA K DELOACHE DC

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	111N00000X	Chiropractor	2858	TX

General Provider Information

NPI Number	:	1619087855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA K DELOACHE DC

Provider Business Mailing Address
First Line	:	1305 WAUGH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-3907
Country	:	US
Telephone Number	:	713-521-2003
Fax Number	:	713-521-2057

Provider Business Practice Location Address
First Line	:	1305 WAUGH DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77019-3907
Country	:	US
Telephone Number	:	713-521-2003
Fax Number	:	713-521-2057

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/08/2007

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