Provider Demographics
NPI:1750362646
Name:RHODES, ANGEL LOUVE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:LOUVE
Last Name:RHODES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 VALLEY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-4987
Mailing Address - Country:US
Mailing Address - Phone:817-426-2349
Mailing Address - Fax:
Practice Address - Street 1:2505 W BELT LINE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-1930
Practice Address - Country:US
Practice Address - Phone:972-230-8290
Practice Address - Fax:972-230-8274
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05648363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX382510YKPWMedicare PIN