| Doctor Name: | MR. RODNEY KYLE BUTH |
| NPI Number: | 1003904509 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | OPA-C |
| License Number: | |
| Business Practice Address: | 6311 Southwest Blvd Benbrook, TX - 761321063 |
| Business Phone Number: | 8177319400 |
| Business Fax Number: | 8177314282 |
| Mailing Address: | 7720 Marble Canyon Dr, FORT WORTH |
| State: | TX |
| Postal Code: | 761374156 |
| Phone Number: | 8179199671 |
| Fax Number: | 8177314282 |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |