Provider Demographics
NPI:1932731171
Name:RODRIGUEZ, ELIZABETH ANDREA (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANDREA
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 W AMARILLO BLVD APT 1611
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79124-2133
Mailing Address - Country:US
Mailing Address - Phone:940-613-4224
Mailing Address - Fax:
Practice Address - Street 1:3552 S SONCY RD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119-6672
Practice Address - Country:US
Practice Address - Phone:806-467-6815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist