Provider Demographics
NPI:1053565606
Name:RODRIGUEZ DME
Entity type:Organization
Organization Name:RODRIGUEZ DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:956-712-3760
Mailing Address - Street 1:1420 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-7956
Mailing Address - Country:US
Mailing Address - Phone:956-712-3760
Mailing Address - Fax:956-753-5995
Practice Address - Street 1:1420 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-7956
Practice Address - Country:US
Practice Address - Phone:956-712-3760
Practice Address - Fax:956-753-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0105472332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies