Provider Demographics
NPI:1649736281
Name:RODRIGUEZ, EULALIO III (PA-C)
Entity Type:Individual
Prefix:MR
First Name:EULALIO
Middle Name:
Last Name:RODRIGUEZ
Suffix:III
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 S CLOSNER BLVD
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4660
Mailing Address - Country:US
Mailing Address - Phone:956-292-0100
Mailing Address - Fax:956-292-2613
Practice Address - Street 1:502 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4660
Practice Address - Country:US
Practice Address - Phone:956-292-0100
Practice Address - Fax:956-292-2613
Is Sole Proprietor?:No
Enumeration Date:2019-02-19
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA12661363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant