Provider Demographics
NPI:1881908077
Name:RODRIGUEZ, SERGIO RICARDO JR (FNP)
Entity type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:RICARDO
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:FNP
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Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-922-7000
Mailing Address - Fax:210-504-4681
Practice Address - Street 1:3327 RESEARCH PLZ STE 307
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-5158
Practice Address - Country:US
Practice Address - Phone:210-223-3543
Practice Address - Fax:210-504-4681
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2023-05-16
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Provider Licenses
StateLicense IDTaxonomies
TXAP119439363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX310112302Medicaid
TX259764YK73Medicare PIN