Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 53296 | MT |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | K2111 | TX |
NPI | 1063434504 |
---|---|
Provider Name | Dr. Francisco Bernardo Rodriguez IV |
First Address | San Antonio, TX 78212-8447 |
Second Address | San Antonio, TX 78258-3477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 21/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00X747 | MEDICARE PTAN (01) | TX |
165996301 | (05) | TX |
8M8861 | BLUE CROSS (01) | TX |
H68463 | (02) | TX |