MEDICARE: DEIRDRE M RHOAD M D 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	174400000X	Specialist	H4642	TX

General Provider Information

NPI Number	:	1679851901
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEIRDRE M RHOAD M D P A

Provider Business Mailing Address
First Line	:	11111 RESEARCH BLVD
Second Line	:	SUITE 310
City	:	AUSTIN
State	:	TX
Zip	:	78759-5264
Country	:	US
Telephone Number	:	512-476-9149
Fax Number	:	512-476-8654

Provider Business Practice Location Address
First Line	:	11111 RESEARCH BLVD
Second Line	:	SUITE 310
City	:	AUSTIN
State	:	TX
Zip	:	78759-5264
Country	:	US
Telephone Number	:	512-476-9149
Fax Number	:	512-476-8654

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEIRDRE RHOAD
Credential	:	M D
Telephone Number	:	512-476-9149

Provider Enumeration Date	:	08/04/2011
Last Update Date	:	08/04/2011

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