Provider Demographics
NPI:1609944305
Name:RODRIGUEZ YAMALLEL, DIEGO MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:DIEGO
Middle Name:MANUEL
Last Name:RODRIGUEZ YAMALLEL
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 1:2821 NORTHGATE LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-6252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1409 S 9TH AVE UNIT 143
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-5549
Practice Address - Country:US
Practice Address - Phone:956-777-0483
Practice Address - Fax:999-999-9999
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG97972084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX134210706Medicaid