Provider Demographics
NPI:1487229274
Name:RODRIQUEZ, ALICIA DELIA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:DELIA
Last Name:RODRIQUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N BEACH ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76111-6613
Mailing Address - Country:US
Mailing Address - Phone:817-831-3388
Mailing Address - Fax:888-448-3903
Practice Address - Street 1:1301 N BEACH ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76111-6613
Practice Address - Country:US
Practice Address - Phone:817-831-3388
Practice Address - Fax:888-448-3903
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor