Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 6893 | TX |
NPI | 1356729305 |
---|---|
Provider Name | Glenda Rodriguez |
First Address | Houston, TX 77031-1924 |
Second Address | Houston, TX 77031-1924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2015 |
Last Update Date | 11/05/2015 |