Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 1023919 | TX |
NPI | 1174533848 |
---|---|
Provider Name | Carlos C Rodriguez, Jr |
First Address | Brownsville, TX 78520 |
Second Address | Brownsville, TX 78520-8717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 17/03/2018 |