Provider Demographics
NPI:1790890929
Name:RODRIGUEZ, MARIA ENEDINA (CNS)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ENEDINA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1200 E SAVANNAH AVE
Mailing Address - Street 2:STE 13
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1728
Mailing Address - Country:US
Mailing Address - Phone:956-668-0974
Mailing Address - Fax:956-668-0751
Practice Address - Street 1:1200 E SAVANNAH AVE
Practice Address - Street 2:STE 13
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1728
Practice Address - Country:US
Practice Address - Phone:956-668-0974
Practice Address - Fax:956-668-0751
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX614065364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8Y0605OtherBCBS
TXP00842309OtherRAILROAD MEDICARE
TX179071901Medicaid
TXP00842309OtherRAILROAD MEDICARE