Provider Demographics
NPI:1114112547
Name:RODRIGUEZ, FRANCISCO JAVIER JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:FRANCISCO
Middle Name:JAVIER
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4351 E LOHMAN AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8262
Mailing Address - Country:US
Mailing Address - Phone:575-532-9755
Mailing Address - Fax:575-532-8881
Practice Address - Street 1:4351 E LOHMAN AVE STE 301
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8262
Practice Address - Country:US
Practice Address - Phone:575-532-9755
Practice Address - Fax:575-532-8881
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2020-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04447363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ52814Medicare UPIN