Individual
TYLER RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
10814 STONE CANYON RD APT 1157, DALLAS, TX 75230-4360
(254) 718-1742
Mailing address
10814 STONE CANYON RD APT 1157, DALLAS, TX 75230-4360
(254) 718-1742
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
336358
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336358
—
TX
Enumeration date
08/05/2020
Last updated
08/05/2020
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