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Individual

WILLIAM J. LODRIGUES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
WHCNP

Contact information

Practice address
5201 HARRY HINES BLVD, MEDICAL STAFF SERVICES, DALLAS, TX 75235-7708
(214) 590-8006
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
(214) 590-4105
(214) 590-4162

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
615010
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8Y0764
BLUE CROSS BLUE SHIELD
TX
Enumeration date
07/14/2006
Last updated
11/20/2007
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