Provider Demographics
NPI:1083404248
Name:VASQUEZ, ROGELIO JR
Entity type:Individual
Prefix:MR
First Name:ROGELIO
Middle Name:
Last Name:VASQUEZ
Suffix:JR
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 CADENA
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78046-8012
Mailing Address - Country:US
Mailing Address - Phone:956-319-8321
Mailing Address - Fax:
Practice Address - Street 1:610 CADENA
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78046-8012
Practice Address - Country:US
Practice Address - Phone:956-319-8321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver