Provider Demographics
NPI:1346655669
Name:RODRIGUEZ, JOSE (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E RIDGE RD STE 6
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1528
Mailing Address - Country:US
Mailing Address - Phone:956-331-8150
Mailing Address - Fax:956-331-8903
Practice Address - Street 1:1200 E RIDGE RD STE 6
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1528
Practice Address - Country:US
Practice Address - Phone:956-331-8150
Practice Address - Fax:956-331-8903
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4626207Q00000X, 207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3786204-08Medicaid
TXH08HV91001OtherBCBS