Organization
GRIGORIY RODONAIA MD PA
Active
Other names
Rodonaia Family Medicine and Aesthetics
Organization subpart
No
Provider details
NPI number
Authorized official
GRIGORIY T RODONAIA MD (DOCTOR/OWNER)
(409) 923-1617
Entity
Organization
Contact information
Practice address
2955 HARRISON ST, STE 200, BEAUMONT, TX 77702-1154
(409) 923-1617
(409) 923-1618
Mailing address
2955 HARRISON ST, STE 200, BEAUMONT, TX 77702-1154
(409) 923-1617
(409) 923-1618
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
M6986
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048SA
BCBS
TX
Enumeration date
01/16/2009
Last updated
03/04/2010
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