Provider Demographics
NPI:1023264579
Name:RODRIGUEZ, HENRY N
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:N
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 544
Mailing Address - Street 2:
Mailing Address - City:LYFORD
Mailing Address - State:TX
Mailing Address - Zip Code:78569-0544
Mailing Address - Country:US
Mailing Address - Phone:956-299-0115
Mailing Address - Fax:
Practice Address - Street 1:7882 BUSINESS 77
Practice Address - Street 2:
Practice Address - City:LYFORD
Practice Address - State:TX
Practice Address - Zip Code:78569
Practice Address - Country:US
Practice Address - Phone:956-299-0115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-15
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000154341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance