Provider Demographics
NPI:1952631285
Name:RODRIGUEZ, ELISA (RCP)
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-7079
Mailing Address - Country:US
Mailing Address - Phone:956-618-4900
Mailing Address - Fax:
Practice Address - Street 1:2245 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-7079
Practice Address - Country:US
Practice Address - Phone:956-618-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX609962279G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGeneral Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60996OtherTEXAS DEPT OF STATE HEALTH SERVICES