Provider Demographics
NPI:1073882924
Name:RENE RODRIGUEZ DMD, PC.
Entity Type:Organization
Organization Name:RENE RODRIGUEZ DMD, PC.
Other - Org Name:AMERICA DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:RODRIGUEZ FARRACH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-457-4051
Mailing Address - Street 1:11682 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-3612
Mailing Address - Country:US
Mailing Address - Phone:281-741-2576
Mailing Address - Fax:
Practice Address - Street 1:11682 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-3612
Practice Address - Country:US
Practice Address - Phone:281-741-2576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26467261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental