Provider Demographics
NPI:1891870408
Name:RODRIGUEZ, ROBERT LOUIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LOUIS
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 1:2803 MOSSROCK
Mailing Address - Street 2:STE 203
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5121
Mailing Address - Country:US
Mailing Address - Phone:210-341-6814
Mailing Address - Fax:210-348-6828
Practice Address - Street 1:2803 MOSSROCK
Practice Address - Street 2:STE 203
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5121
Practice Address - Country:US
Practice Address - Phone:210-341-6814
Practice Address - Fax:210-348-6828
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX180091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice