GRIGORIY RODONAIA MD PA NPI 1497992127

NPI Information

NPI: 1497992127
Provider Name: GRIGORIY RODONAIA MD PA

Doing Business As: RODONAIA FAMILY MEDICINE AND AESTHETICS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
2955 HARRISON ST
STE 200
BEAUMONT, TX
ZIP 77702
Phone: (409) 923-1617
Get Directions

GRIGORIY RODONAIA MD PA is a primary care clinic center in Beaumont, TX. GRIGORIY RODONAIA MD PA NPI is 1497992127. The provider is registered as an organization entity type.
The provider Is Doing Business As Rodonaia Family Medicine And Aesthetics.

The provider's business location address is:

2955 HARRISON ST
STE 200
BEAUMONT, TX
ZIP 77702-154
Phone: (409) 923-1617
Fax: (409) 923-1618

The provider's authorized official is Grigoriy T Rodonaia .
The authorized official title is Doctor/owner and has the following contact phone number (409) 923-1617.

The CLIA number assigned to this NPI record is 45D1107138 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2009 and was last updated on 3/4/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	M6986	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	OA3611	MEDICARE PIN	TEXAS
2	0048SA	OTHER	TEXAS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »