Provider Demographics
NPI:1740354596
Name:RODRIGUEZ, TOMAS (PHD ANP-C PMHCNS-BC)
Entity type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PHD ANP-C PMHCNS-BC
Other - Prefix:DR
Other - First Name:TOM
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, RN, NP, CNS
Mailing Address - Street 1:13201 NORTHWEST FWY STE 770
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6233
Mailing Address - Country:US
Mailing Address - Phone:713-523-4333
Mailing Address - Fax:713-523-4493
Practice Address - Street 1:13201 NORTHWEST FWY STE 770
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-6233
Practice Address - Country:US
Practice Address - Phone:713-523-4333
Practice Address - Fax:713-523-4493
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX548373363LA2200X, 364SG0600X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology