Provider Demographics
NPI:1891822334
Name:RODRIGUEZ, ALEXIA (DC)
Entity Type:Individual
Prefix:
First Name:ALEXIA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 FORTVIEW RD STE 102
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7659
Mailing Address - Country:US
Mailing Address - Phone:512-326-5700
Mailing Address - Fax:512-326-5702
Practice Address - Street 1:1714 FORTVIEW RD STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7659
Practice Address - Country:US
Practice Address - Phone:512-326-5700
Practice Address - Fax:512-326-5702
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8R1104OtherBLUECROSS BLUESHIELD ID
TX1055733OtherBLUELINK ID