Individual
ARACELY C RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSA
Contact information
Practice address
7414 BROOKPORT, SAN ANTONIO, TX 78238-3528
(956) 346-7243
Mailing address
7414 BROOKPORT, SAN ANTONIO, TX 78238-3528
(956) 346-7243
(956) 346-7243
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12678965
CAQH
TX
01
—
134781
NBSTSA BOARD CERTIFICATION
—
01
—
82NN17
BCBS
TX
01
—
SA00494
LSA LICENSE
TX
Enumeration date
09/21/2012
Last updated
06/16/2024
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