Provider Demographics
NPI:1851028120
Name:RODRIGUEZ, STEVEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3604 LIBERTY WAY
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-3101
Mailing Address - Country:US
Mailing Address - Phone:469-556-0784
Mailing Address - Fax:469-840-3908
Practice Address - Street 1:12835 PRESTON RD STE 202
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1459
Practice Address - Country:US
Practice Address - Phone:214-373-5300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist