Individual
MRS. GRACE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1370 EMERALD GATE LN, EL PASO, TX 79936-7261
(915) 503-6220
Mailing address
1370 EMERALD GATE LN, EL PASO, TX 79936-7261
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14609158
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14609158
NA
TX
Enumeration date
03/25/2020
Last updated
03/25/2020
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