Provider Demographics
NPI:1932854775
Name:RODRIGUEZ OCHOA, MANUEL ALEJANDRO (PHARMD)
Entity Type:Individual
Prefix:
First Name:MANUEL
Middle Name:ALEJANDRO
Last Name:RODRIGUEZ OCHOA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3256 RICHMOND AVE # B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79930-4420
Mailing Address - Country:US
Mailing Address - Phone:915-701-7027
Mailing Address - Fax:
Practice Address - Street 1:10301 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:SOCORRO
Practice Address - State:TX
Practice Address - Zip Code:79927-1605
Practice Address - Country:US
Practice Address - Phone:915-245-3493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69993183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist