Provider Demographics
NPI:1649456252
Name:LINDA A. RODRIGUE,MD, PLLC
Entity type:Organization
Organization Name:LINDA A. RODRIGUE,MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-291-3644
Mailing Address - Street 1:950 E. BELTLINE RD
Mailing Address - Street 2:STE#130
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104
Mailing Address - Country:US
Mailing Address - Phone:972-291-3644
Mailing Address - Fax:972-291-3659
Practice Address - Street 1:950 E. BELTLINE RD
Practice Address - Street 2:STE#130
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104
Practice Address - Country:US
Practice Address - Phone:972-291-3644
Practice Address - Fax:972-291-3659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8289207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0046QWOtherBLUE CROSS & BLUE SHIELD OF TEXAS
E23508OtherUPIN
TX195092501Medicaid
TX00Z265Medicare PIN