Provider Demographics
NPI:1710089750
Name:RODRIGUEZ, RUBEN (DDS)
Entity Type:Individual
Prefix:MR
First Name:RUBEN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:701 E. EDINBURG AVE. SUITE B
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-0458
Mailing Address - Country:US
Mailing Address - Phone:956-262-1888
Mailing Address - Fax:956-262-7572
Practice Address - Street 1:701-B E. EDINBURG AVE.
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543
Practice Address - Country:US
Practice Address - Phone:956-262-1888
Practice Address - Fax:956-262-7572
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX213291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice