Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1167053 | TX |
N | 2251C2600X | Cardiopulmonary | 1167053 | TX |
N | 2251G0304X | Physical Therapist - Geriatrics | 1167053 | TX |
N | 2251N0400X | Physical Therapist - Neurology | 1167053 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1167053 | TX |
N | 225200000X | Physical Therapy Assistant | 1167053 | TX |
NPI | 1831552231 |
---|---|
Provider Name | Lourdes Rodriguez |
First Address | Helotes, TX 78023-0758 |
Second Address | San Antonio, TX 78249-3825 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2016 |
Last Update Date | 01/04/2016 |