Provider Demographics
NPI:1295864346
Name:RODRIGUEZ, EDEN MAE CAMARINES (RPH, PHARMD, BCPS)
Entity Type:Individual
Prefix:DR
First Name:EDEN MAE
Middle Name:CAMARINES
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RPH, PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 CREEKWAY DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7564
Mailing Address - Country:US
Mailing Address - Phone:214-264-7794
Mailing Address - Fax:
Practice Address - Street 1:6201 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-8162
Practice Address - Country:US
Practice Address - Phone:214-633-2307
Practice Address - Fax:214-633-8843
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX44603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist