MEDICARE: MARCUS RHODES DDS

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	122300000X	Dentist	DE60367261	WA
2	122300000X	Dentist	35043	TX

General Provider Information

NPI Number	:	1770984551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS RHODES DDS

Provider Business Mailing Address
First Line	:	7850 W GRAND PKWY S STE 400
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5884
Country	:	US
Telephone Number	:	281-769-1080
Fax Number	:	281-769-1090

Provider Business Practice Location Address
First Line	:	7850 W GRAND PKWY S STE 400
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-5884
Country	:	US
Telephone Number	:	281-769-1080
Fax Number	:	281-769-1090

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

Provider Enumeration Date	:	09/11/2014
Last Update Date	:	07/13/2021

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