Provider Demographics
NPI:1326284514
Name:RODRIGUEZ, LUIS JAVIER (FNP-C)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:JAVIER
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26103 GLENBRIAR SPRING LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-1355
Mailing Address - Country:US
Mailing Address - Phone:281-256-2359
Mailing Address - Fax:
Practice Address - Street 1:26103 GLENBRIAR SPRING LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1355
Practice Address - Country:US
Practice Address - Phone:281-256-2359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-18
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601953363LF0000X
OR202106694NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily