Provider Demographics
NPI:1609964105
Name:RODRIGUEZ, PABLO S (MD)
Entity Type:Individual
Prefix:DR
First Name:PABLO
Middle Name:S
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1215 S COULTER ST
Mailing Address - Street 2:SUITE 401
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1758
Mailing Address - Country:US
Mailing Address - Phone:806-356-2280
Mailing Address - Fax:806-677-2029
Practice Address - Street 1:1215 S COULTER ST
Practice Address - Street 2:SUITE 401
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1758
Practice Address - Country:US
Practice Address - Phone:806-356-2280
Practice Address - Fax:806-677-2029
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXJ2463207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF94293Medicare UPIN