Provider Demographics
NPI:1295760932
Name:RODRIGUEZ, RAFAEL H (RT)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:H
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2627 WELLS CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6943
Mailing Address - Country:US
Mailing Address - Phone:972-523-6815
Mailing Address - Fax:888-846-7701
Practice Address - Street 1:2627 WELLS CT
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-6943
Practice Address - Country:US
Practice Address - Phone:972-523-6815
Practice Address - Fax:888-846-7701
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5810247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX459898OtherBLUE CROSS/ BLUE SHIELD
TX459898Medicare ID - Type UnspecifiedPORTABLE X-RAY