MEDICARE: DR. RHONDA BIGHAM THROCKMORTON PSYD

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	103TC0700X	Clinical Psychologist	32272	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0090LV	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1841340189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RHONDA BIGHAM THROCKMORTON PSYD

Provider Business Mailing Address
First Line	:	123 COMMERCE
Second Line	:	SUITE A
City	:	KERRVILLE
State	:	TX
Zip	:	78028
Country	:	US
Telephone Number	:	830-792-4477
Fax Number	:	830-792-4546

Provider Business Practice Location Address
First Line	:	222 SIDNEY BAKER ST S STE 350
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5900
Country	:	US
Telephone Number	:	830-285-1215
Fax Number	:	830-257-0086

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

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	10/07/2024

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