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Individual
JOSE R RODRIGUEZ
Active
Individual
JOSE R RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04899
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1071690
NCCPA CERTIFICATION
TX
01
—
D0171280
DPS REGISTRATION
TX
01
—
PA04899
TX MEDICAL BOARD LICENSE/PERMIT
TX
Enumeration date
09/13/2006
Last updated
03/07/2023
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