Organization
CRYSTAL CITY ISD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRES RODRIGUEZ JR. LAT (ATHLETIC TRAINER)
(830) 374-2341
Entity
Organization
Contact information
Practice address
805 E CROCKETT ST, CRYSTAL CITY, TX 78839-2711
(830) 374-2341
Mailing address
805 E CROCKETT ST, CRYSTAL CITY, TX 78839-2711
(830) 374-2341
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
AT5507
TX
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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