Individual
DR. ILDEFONSO ISMAEL RODRIGUEZ-RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2829 BABCOCK RD STE 300, SAN ANTONIO, TX 78229-6011
(210) 580-9500
(210) 568-4397
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10039991
TX
207RH0000X
Hematology (Internal Medicine) Physician
279093
NY
207RH0003X
Hematology & Oncology Physician
Primary
PHYTEMP
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
341471603
—
TX
Enumeration date
04/20/2011
Last updated
10/04/2021
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