Provider Demographics
NPI:1326020975
Name:RODRIGUEZ, HECTOR DONALD (MD)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:DONALD
Last Name:RODRIGUEZ
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 1:8940 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1646
Mailing Address - Country:US
Mailing Address - Phone:913-384-5589
Mailing Address - Fax:913-596-2422
Practice Address - Street 1:8940 STATE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1646
Practice Address - Country:US
Practice Address - Phone:913-384-5589
Practice Address - Fax:913-596-2422
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-23191207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSQ191672AMedicare ID - Type Unspecified
KSE59157Medicare UPIN