MEDICARE: RHODES BAGWELL PLLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1962832600
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RHODES BAGWELL PLLC

Provider Business Mailing Address
First Line	:	13130 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-7220
Country	:	US
Telephone Number	:	713-977-8464
Fax Number	:	713-977-8496

Provider Business Practice Location Address
First Line	:	13130 MEMORIAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-7220
Country	:	US
Telephone Number	:	713-977-8464
Fax Number	:	713-977-8496

Authorized Official
Title or Position	:	OD/OWNER
Name	:	ASHLEY R. BAGWELL
Credential	:	OD/OWNER
Telephone Number	:	713-977-8464

Provider Enumeration Date	:	11/15/2013
Last Update Date	:	09/27/2024

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