Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | K1030 | TX |
NPI | 1023075496 |
---|---|
Provider Name | Dr. Victor Manuel Rodriguez |
First Address | Houston, TX 77074-5005 |
Second Address | Houston, TX 77074-5005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 09/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
096596402 | (05) | TX |
D39093 | (02) | TX |