Provider Demographics
NPI:1306206628
Name:GABE RODRIGUEZ M.D., P.A.
Entity Type:Organization
Organization Name:GABE RODRIGUEZ M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-363-0970
Mailing Address - Street 1:14403 WINDY CRK
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4531
Mailing Address - Country:US
Mailing Address - Phone:210-538-2273
Mailing Address - Fax:210-695-3783
Practice Address - Street 1:14418 OLD BANDERA RD
Practice Address - Street 2:
Practice Address - City:HELOTES
Practice Address - State:TX
Practice Address - Zip Code:78023-3702
Practice Address - Country:US
Practice Address - Phone:210-538-2273
Practice Address - Fax:210-695-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9619261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care