Provider Demographics
NPI:1952512246
Name:RODRIGUEZ, SIMON SERGIO (MD)
Entity Type:Individual
Prefix:DR
First Name:SIMON
Middle Name:SERGIO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1310 MURCHISON DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902
Mailing Address - Country:US
Mailing Address - Phone:915-544-4500
Mailing Address - Fax:915-546-9430
Practice Address - Street 1:1310 MURCHISON DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902
Practice Address - Country:US
Practice Address - Phone:915-544-4500
Practice Address - Fax:915-544-4572
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2015-05-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN5366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine