Provider Demographics
NPI:1306932363
Name:ROLANDO F. RODRIGUEZ MD
Entity type:Organization
Organization Name:ROLANDO F. RODRIGUEZ MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:ROLANDO
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-828-5247
Mailing Address - Street 1:102 PINEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6727
Mailing Address - Country:US
Mailing Address - Phone:210-828-5247
Mailing Address - Fax:210-828-7244
Practice Address - Street 1:1712 BUENA VISTA ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-3803
Practice Address - Country:US
Practice Address - Phone:210-226-6562
Practice Address - Fax:210-222-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9639174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXN802Medicare ID - Type Unspecified
TXC21194Medicare UPIN