Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M2053 | TX |
Y | 2080P0207X | Pediatric Hematology-Oncologist | M2053 | TX |
NPI | 1073541223 |
---|---|
Provider Name | Nidra I Rodriguez |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 15/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8K9798 | BCBS (01) | TX |
I37630 | (02) | TX |