Organization
LIVE OAK PEDIATRICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS LUIS RODRIGUEZ III MD (DIRECTOR, LIVE OAK PEDIATRICS)
(210) 599-6251
Entity
Organization
Contact information
Practice address
12702 TOEPPERWEIN RD, STE 132, LIVE OAK, TX 78233-3278
(210) 599-6251
(210) 599-6254
Mailing address
12702 TOEPPERWEIN RD, STE 132, LIVE OAK, TX 78233-3278
(210) 599-6251
(210) 599-6254
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I15074
UPIN
—
Enumeration date
07/23/2007
Last updated
07/23/2007
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