Provider Demographics
NPI:1043798101
Name:RODRIGUEZ, MARIO ALBERTO JR (AGACNP)
Entity Type:Individual
Prefix:MR
First Name:MARIO
Middle Name:ALBERTO
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:AGACNP
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Mailing Address - Street 1:3833 DUNLAVY ST APT 346
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-4750
Mailing Address - Country:US
Mailing Address - Phone:832-398-4981
Mailing Address - Fax:
Practice Address - Street 1:4000 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1202
Practice Address - Country:US
Practice Address - Phone:713-359-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP138280363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine