Provider Demographics
NPI:1982798500
Name:RODRIGUE, LINDA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ANN
Last Name:RODRIGUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 S COOPER ST
Mailing Address - Street 2:SUITE 245
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3445
Mailing Address - Country:US
Mailing Address - Phone:817-419-9600
Mailing Address - Fax:817-419-9602
Practice Address - Street 1:3701 S COOPER ST
Practice Address - Street 2:SUITE 245
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3445
Practice Address - Country:US
Practice Address - Phone:817-419-9600
Practice Address - Fax:817-419-9602
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOBR0179906207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8AW860OtherBLUE CROSS BLUE SHIELD
TX195093301Medicaid
MOE23508Medicare UPIN
TX8AW860OtherBLUE CROSS BLUE SHIELD