Organization
FONZ SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDELFONSO R RODRIGUEZ JR. CSFA (OWNER)
(210) 364-2815
Entity
Organization
Contact information
Practice address
4503 CORNUDO RDG, SAN ANTONIO, TX 78251-4962
(214) 227-2457
(214) 764-0880
Mailing address
PO BOX 2550, ROWLETT, TX 75030-2550
(214) 227-2457
(214) 764-0880
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
01/18/2022
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