Provider Demographics
NPI:1114203437
Name:RFBF PEDIATRIC URGENT CARE PA
Entity Type:Organization
Organization Name:RFBF PEDIATRIC URGENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:2102-845-8980
Mailing Address - Street 1:1207 N LOOP 1604 W
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4628
Mailing Address - Country:US
Mailing Address - Phone:210-479-3474
Mailing Address - Fax:210-479-3477
Practice Address - Street 1:1207 N LOOP 1604 W
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4629
Practice Address - Country:US
Practice Address - Phone:210-479-3474
Practice Address - Fax:210-479-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty