Provider Demographics
NPI:1841885837
Name:RODRIGUEZ, LUIS REMIGIO (LMT)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:REMIGIO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 BURTON LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4611
Mailing Address - Country:US
Mailing Address - Phone:541-743-1558
Mailing Address - Fax:
Practice Address - Street 1:5441 BURTON LN
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4611
Practice Address - Country:US
Practice Address - Phone:541-743-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24335225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist