Individual
JUANITA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
10609 W IH 10 STE 105, SAN ANTONIO, TX 78230-1673
(210) 344-5437
(210) 340-1259
Mailing address
10609 W IH 10 STE 105, SAN ANTONIO, TX 78230-1673
(210) 344-5437
(210) 340-1259
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
207745
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173913801
—
TX
Enumeration date
09/07/2018
Last updated
09/07/2018
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