Provider Demographics
NPI:1124642137
Name:RODRIGUEZ, KARLA LIZETTE
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:LIZETTE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 W CESAR E CHAVEZ BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-4023
Mailing Address - Country:US
Mailing Address - Phone:210-937-2104
Mailing Address - Fax:
Practice Address - Street 1:3215 W CESAR E CHAVEZ BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-4023
Practice Address - Country:US
Practice Address - Phone:210-937-2104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX986988163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse