Individual
ANDREA DYAN MARI RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
7710 W INTERSTATE 10, SAN ANTONIO, TX 78230-4711
(210) 377-3355
Mailing address
8210 MEADOW SWAN ST, SAN ANTONIO, TX 78251-2319
(210) 769-2279
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
305603
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164X00000X
—
TX
Enumeration date
08/03/2018
Last updated
08/03/2018
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