Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 36595 | TX |
NPI | 1093327108 |
---|---|
Provider Name | Dr. Hevony Rodriguez |
First Address | Laredo, TX 78041-3722 |
Second Address | Laredo, TX 78041-1705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2020 |
Last Update Date | 19/08/2020 |