Provider Demographics
NPI:1235181421
Name:SACA, RODOLFO ANTONIO (MD)
Entity Type:Individual
Prefix:DR
First Name:RODOLFO
Middle Name:ANTONIO
Last Name:SACA
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 1:2121 PEASE SUITE 601
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-423-0112
Mailing Address - Fax:956-423-0188
Practice Address - Street 1:2121 PEASE ST STE 601
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8326
Practice Address - Country:US
Practice Address - Phone:956-423-0112
Practice Address - Fax:956-423-0188
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG74492080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115790106Medicaid
TXUE80392Medicare UPIN