Provider Demographics
NPI:1093865941
Name:RODRIGUEZ, ROLANDO XAVIER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLANDO
Middle Name:XAVIER
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9813 SANDHILL
Mailing Address - Street 2:UNIT 36
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-8652
Mailing Address - Country:US
Mailing Address - Phone:956-236-4735
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ17722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0004407308OtherAETNA
TX86W140OtherBLUE CROSS BLUE SHIELD
TX742645335001OtherSTAR HRG