Provider Demographics
NPI:1306247853
Name:RODRIGUEZ, MONIKA (NP)
Entity type:Individual
Prefix:MRS
First Name:MONIKA
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:MONIKA
Other - Middle Name:
Other - Last Name:KOVACS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11614 FM 2244 RD
Mailing Address - Street 2:STE 130
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-5551
Mailing Address - Country:US
Mailing Address - Phone:512-263-3911
Mailing Address - Fax:512-263-3933
Practice Address - Street 1:11614 FM 2244 RD
Practice Address - Street 2:STE 130
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-5551
Practice Address - Country:US
Practice Address - Phone:512-263-3911
Practice Address - Fax:512-263-3933
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126133363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX402470YM8AMedicare PIN