Provider Demographics
NPI:1194984781
Name:RODRIGUEZ, JOSE ANTONIO (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:ANTONIO
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6750 E SAM HOUSTON PKWY N
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77049-4041
Mailing Address - Country:US
Mailing Address - Phone:832-328-5612
Mailing Address - Fax:832-328-5614
Practice Address - Street 1:6750 E SAM HOUSTON PKWY N
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77049-4041
Practice Address - Country:US
Practice Address - Phone:832-328-5612
Practice Address - Fax:832-328-5614
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2022-01-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP0870207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine