Provider Demographics
NPI:1629510573
Name:RODRIGUEZ, DANIEL IVAN (APRN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:IVAN
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-0008
Mailing Address - Country:US
Mailing Address - Phone:956-647-8600
Mailing Address - Fax:956-969-9564
Practice Address - Street 1:1001 JAMES ST
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-0008
Practice Address - Country:US
Practice Address - Phone:956-647-8600
Practice Address - Fax:956-969-9564
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily