Doctor Name: | DR. RAUL MARCELO RODRIGUEZ |
NPI Number: | 1477680080 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D., M.P.H. |
License Number: | G6867 |
Business Practice Address: | 12023 Edward Conrad San Antonio, TX - 782535092 |
Business Phone Number: | 3619061554 |
Business Fax Number: | |
Mailing Address: | 12023 Edward Conrad, SAN ANTONIO |
State: | TX |
Postal Code: | 782535092 |
Phone Number: | 3619061554 |
Fax Number: | |
NPI Enumeration Date: | 02/28/2007 |
NPI Last Update Date: | 01/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G6867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |