Provider Demographics
NPI:1841365269
Name:RODRIGUEZ, ADAM A (DC, NP-C)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 WHISPERING PINE BLVD
Mailing Address - Street 2:
Mailing Address - City:MELISSA
Mailing Address - State:TX
Mailing Address - Zip Code:75454-2643
Mailing Address - Country:US
Mailing Address - Phone:972-658-0953
Mailing Address - Fax:
Practice Address - Street 1:3105 WHISPERING PINE BLVD
Practice Address - Street 2:
Practice Address - City:MELISSA
Practice Address - State:TX
Practice Address - Zip Code:75454-2643
Practice Address - Country:US
Practice Address - Phone:972-658-0953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6757111N00000X
TXAP132710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
52838OtherNATIONAL LICENSE
V02549Medicare UPIN
TX611232Medicare ID - Type Unspecified