Provider Demographics
NPI:1164472213
Name:RODRIGUEZ, ALFRED JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:ALFRED
Middle Name:JOSEPH
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 W PARKER RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7939
Mailing Address - Country:US
Mailing Address - Phone:972-981-7800
Mailing Address - Fax:972-981-7808
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:SUITE 215
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7939
Practice Address - Country:US
Practice Address - Phone:972-981-7800
Practice Address - Fax:972-981-7808
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6588207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC21209Medicare UPIN