Provider Demographics
NPI:1770732505
Name:JOSE A RODRIGUEZ PA-C LLC
Entity type:Organization
Organization Name:JOSE A RODRIGUEZ PA-C LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PA-C
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:956-783-9100
Mailing Address - Street 1:1044 W ACACIA AVE
Mailing Address - Street 2:STE B
Mailing Address - City:ALAMO
Mailing Address - State:TX
Mailing Address - Zip Code:78516
Mailing Address - Country:US
Mailing Address - Phone:956-783-9100
Mailing Address - Fax:956-783-9809
Practice Address - Street 1:1044 W ACACIA AVE
Practice Address - Street 2:STE B
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516
Practice Address - Country:US
Practice Address - Phone:956-783-9100
Practice Address - Fax:956-783-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty