Individual
DR. RODOLFO V. GRANADOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2106 ELM VIS, SAN ANTONIO, TX 78230-2772
(210) 614-3371
(210) 614-1055
Mailing address
PO BOX 8887, GREENVILLE, TX 75404-8887
(210) 621-0640
(210) 621-2517
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F9494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050004558
RAILROAD MEDICARE
TX
01
—
103525500
USDOL
TX
05
—
126279203
—
TX
Enumeration date
09/13/2006
Last updated
12/28/2016
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