Individual
JACQUELINE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5420 WEST LOOP S, SUITE 2300, BELLAIRE, TX 77401-2107
(713) 650-6900
(713) 655-0956
Mailing address
PO BOX 169, TEXAS CITY, TX 77592-0169
(713) 650-6900
(713) 655-0956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10543
TX
363AM0700X
Medical Physician Assistant
PA10543
TX
363AS0400X
Surgical Physician Assistant
PA10543
TX
Other
Enumeration date
06/29/2016
Last updated
03/29/2018
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