Individual
MRS. NORMA JEAN RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CREDENTIALING SPEC
Contact information
Practice address
427 9TH ST, SAN ANTONIO, TX 78215-1528
(210) 951-3280
(210) 858-9220
Mailing address
250 GOLDEN CROWN DR, SAN ANTONIO, TX 78223-2713
(210) 214-2111
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1111111
NO BILLING NEEDED
TX
Enumeration date
08/31/2020
Last updated
08/31/2020
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