Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 8857 | TX |
N | 111NX0100X | Occupational Health | 8857 | TX |
NPI | 1043369952 |
---|---|
Provider Name | Dr. Rogelio Gabriel Rodriguez |
First Address | Houston, TX 77007-5434 |
Second Address | Houston, TX 77007-5434 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 23/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
753014500 | EMPLOYER IDENTIFICATION (01) | TX |