Individual
GRACIELA RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
15634 WALLISVILLE RD STE 900, HOUSTON, TX 77049-4636
(281) 864-5073
Mailing address
15634 WALLISVILLE RD STE 900, HOUSTON, TX 77049-4636
(281) 864-5073
(281) 864-5075
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
24146
TX
1223G0001X
General Practice Dentistry
24146
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487809299
—
TX
Enumeration date
11/20/2008
Last updated
10/24/2022
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