Individual
CODY RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6551 HARRIS PKWY STE 250, FORT WORTH, TX 76132-6115
(817) 263-6116
Mailing address
1240 FOREST PARK DR, WEATHERFORD, TX 76087-2804
(405) 204-6165
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
805416
TX
363LG0600X
Gerontology Nurse Practitioner
805416
TX
Other
Enumeration date
02/05/2018
Last updated
04/09/2018
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