Provider Demographics
NPI:1952535379
Name:RODRIGUEZ, AMARILLYS (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMARILLYS
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 OUTREAU DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-6162
Mailing Address - Country:US
Mailing Address - Phone:361-991-9300
Mailing Address - Fax:361-991-9350
Practice Address - Street 1:4918 HOLLY RD STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4764
Practice Address - Country:US
Practice Address - Phone:361-991-9300
Practice Address - Fax:361-991-9350
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156430225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist