Provider Demographics
NPI:1376585489
Name:RODARTE, GALO A (MD)
Entity Type:Individual
Prefix:DR
First Name:GALO
Middle Name:A
Last Name:RODARTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:400 E ROBINSON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2619
Mailing Address - Country:US
Mailing Address - Phone:915-532-9220
Mailing Address - Fax:915-532-9230
Practice Address - Street 1:400 E ROBINSON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-2619
Practice Address - Country:US
Practice Address - Phone:915-532-9220
Practice Address - Fax:915-532-9230
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3838207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096472802Medicaid
G53956Medicare UPIN
TX096472802Medicaid