Provider Demographics
NPI:1467725275
Name:RODRIGUEZ, ARICK ANGEL (OPA-C, SA-C)
Entity Type:Individual
Prefix:
First Name:ARICK
Middle Name:ANGEL
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:OPA-C, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 1700
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10905 MEMORIAL HERMANN DR STE 120
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3490
Practice Address - Country:US
Practice Address - Phone:281-997-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246Z00000X
TX981246ZC0007X
TX13-309246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
981OtherNATIONAL BOARD OF ORTHOPEDIC PHYSICIAN ASSISTANTS