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Individual

EVA L RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
14636 S FM 2790 W, SUITE 4, LYTLE, TX 78052-4540
(210) 681-0603
(210) 681-3992
Mailing address
19775 BRUCE ST, LYTLE, TX 78052-3421
(210) 681-0603

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1000732
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3113680-01
TX
Enumeration date
04/24/2012
Last updated
07/17/2015
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