Provider Demographics
NPI:1043472491
Name:INTERNATIONAL NEURO PSYCHIATRIC ASSOCIATES
Entity Type:Organization
Organization Name:INTERNATIONAL NEURO PSYCHIATRIC ASSOCIATES
Other - Org Name:ROLANDO X RODRIGUEZ
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:X
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-225-5723
Mailing Address - Street 1:130 W WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-3456
Mailing Address - Country:US
Mailing Address - Phone:210-225-5723
Mailing Address - Fax:956-795-0964
Practice Address - Street 1:130 W WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-3456
Practice Address - Country:US
Practice Address - Phone:210-225-5723
Practice Address - Fax:956-795-0964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1772174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0004407308OtherENTNA
TX86W140OtherBCBS
TX86W140OtherBCBS