Individual
JOSE RAUL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
23 TERRAVALE CT, SPRING, TX 77381-3504
(956) 459-7027
Mailing address
23 TERRAVALE CT, SPRING, TX 77381-3504
(956) 459-7027
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
E0278
TX
208600000X
Surgery Physician
E0278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00N027
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
020045338
MEDICARE RAILROAD
TX
05
—
120451305
—
TX
Enumeration date
03/25/2006
Last updated
01/26/2021
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