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Individual

LUIS RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCDC

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
(254) 724-2111

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
5515
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8637BH
BLUE SHIELD
TX
Enumeration date
04/08/2006
Last updated
05/20/2021
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