Provider Demographics
NPI:1164575817
Name:RODRIGUEZ, BENJAMIN EDWARD JR (AUD)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:EDWARD
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1966 INWOOD RD.
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7298
Mailing Address - Country:US
Mailing Address - Phone:214-905-3010
Mailing Address - Fax:214-905-3022
Practice Address - Street 1:1966 INWOOD RD.
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7298
Practice Address - Country:US
Practice Address - Phone:214-905-3010
Practice Address - Fax:214-905-3022
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80033231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter