Provider Demographics
NPI:1184809295
Name:RODRIGUEZ HAND REHABILITATION AND PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:RODRIGUEZ HAND REHABILITATION AND PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:C
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:LPT, CHT
Authorized Official - Phone:956-412-3226
Mailing Address - Street 1:2390 CENTRAL BOULEVARD
Mailing Address - Street 2:SUITE Q
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520
Mailing Address - Country:US
Mailing Address - Phone:956-544-6467
Mailing Address - Fax:956-544-2556
Practice Address - Street 1:2390 CENTRAL BOULEVARD
Practice Address - Street 2:SUITE Q
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520
Practice Address - Country:US
Practice Address - Phone:956-544-6467
Practice Address - Fax:956-544-2556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXOT01954225X00000X
TXPT10239192251H1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86903TOtherBLUECROSS & BLUESHIELD
TX1174533848OtherNPI
TXOT01954OtherSTATE LICENSE
TX85751TOtherBLUECROSS & BLUESHIELD
TX1831107572OtherNPI
TXPT1023919OtherSTATE LICENSE
TX1174533848OtherNPI
TX653010Medicare PIN