Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | J1423 | TX |
NPI | 1184683104 |
---|---|
Provider Name | Dr. Rodolfo J Walss |
First Address | Brownsville, TX 78526-4120 |
Second Address | Brownsville, TX 78526-4120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2006 |
Last Update Date | 03/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
132572207 | (05) | TX |
F27553 | (02) | TX |