Provider Demographics
NPI:1972871374
Name:RODRIGUEZ, JOSHUA MATTHEW (MD, PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MATTHEW
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD, PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:1901 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5113
Practice Address - Country:US
Practice Address - Phone:915-544-6750
Practice Address - Fax:915-532-4259
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007646183500000X
TXT2053207R00000X, 207RH0003X
CA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No183500000XPharmacy Service ProvidersPharmacist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX426491301Medicaid