Provider Demographics
NPI:1760100374
Name:RODRIGUEZ, MELANIE MARIE
Entity Type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 RESACA BND
Mailing Address - Street 2:
Mailing Address - City:OLMITO
Mailing Address - State:TX
Mailing Address - Zip Code:78575-9425
Mailing Address - Country:US
Mailing Address - Phone:956-404-8863
Mailing Address - Fax:
Practice Address - Street 1:3600 N GARFIELD ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-6329
Practice Address - Country:US
Practice Address - Phone:956-404-8863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program