Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | AP135871 | TX |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP135871 | TX |
NPI | 1023522331 |
---|---|
Provider Name | Richard Michael Rodriguez |
First Address | Los Fresnos, TX 78566-3101 |
Second Address | Brownsville, TX 78520-3984 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2017 |
Last Update Date | 01/02/2022 |