Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | J8744 | TX |
NPI | 1063509347 |
---|---|
Provider Name | Dr. Gabriel Rodriguez |
First Address | Houston, TX 77058-3676 |
Second Address | Houston, TX 77058-3676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
104588201 | (05) | TX |
104588208 | (05) | TX |
H05486 | (02) | TX |
P01142870 | RAILROAD MEDICARE (01) | TX |