Provider Demographics
NPI:1811972896
Name:MOLDES-RODRIGUEZ, ORESTES (MD)
Entity type:Individual
Prefix:DR
First Name:ORESTES
Middle Name:
Last Name:MOLDES-RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 N OREGON ST
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3594
Mailing Address - Country:US
Mailing Address - Phone:915-532-2445
Mailing Address - Fax:915-532-2673
Practice Address - Street 1:1600 N OREGON ST
Practice Address - Street 2:SUITE 1-A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3594
Practice Address - Country:US
Practice Address - Phone:915-532-2445
Practice Address - Fax:915-532-2673
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2691207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ2691OtherTEXAS PHYSICIAN LICENSE
TX123577201OtherMEDICAIL
TXF40171Medicare UPIN
TX8523K0Medicare ID - Type Unspecified