Roderick Tillman

Primary specialty

ContractorTaxonomy code 171W00000X

Practice address

423 Mason Park Blvd Ste C
Katy, TX 77450-6227

Phone

(281) 944-5951

Fax

(832) 565-1413

NPI assigned

Apr 2, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amazing Soldiers,Inc

  • Voluntary or Charitable Agency
  • Houston, TX
  • NPI 1538621610
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1699237230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3880 GREENHOUSE RD STE 406",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770843486",
            "telephone_number": "281-944-5951",
            "fax_number": "832-565-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 MASON PARK BLVD STE C",
            "city": "KATY",
            "state": "TX",
            "postal_code": "774506227",
            "telephone_number": "281-944-5951",
            "fax_number": "832-565-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLMAN",
        "first_name": "RODERICK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-02",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@theschoolofknock.org",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3880 Greenhouse Rd Ste 406",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770843486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shamice Thurston
• Omoladun Ajoke Tiamiyu, M.A
• Katrina Tie
• Jacqueline Tien, RD, LD
• Haley Tijerina, PTA
• Tim Salau
• Tina Baker
• Jose Honkao Ting, MD
• Tiffani Tinnell
• Tippit Dental Group Cinco Ranch PLLC

• Contractor in Katy, TX
• Providers in Katy, TX by specialty
• Contractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.