Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | E6588 | TX |
NPI | 1164472213 |
---|---|
Provider Name | Alfred Joseph Rodriguez |
First Address | Plano, TX 75093-7939 |
Second Address | Plano, TX 75093-7939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C21209 | (02) | TX |