Provider Demographics
NPI:1215386453
Name:RODRIGUEZ, BARBARA A (OWNER/ADMINISTRATOR)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:OWNER/ADMINISTRATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 592318
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-0165
Mailing Address - Country:US
Mailing Address - Phone:210-417-4480
Mailing Address - Fax:210-382-2582
Practice Address - Street 1:1145 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-3327
Practice Address - Country:US
Practice Address - Phone:210-417-4480
Practice Address - Fax:210-384-2582
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX017426372500000X, 372600000X, 3747A0650X, 376J00000X, 3747P1801X
0174263747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No376J00000XNursing Service Related ProvidersHomemaker