Provider Demographics
NPI:1407217607
Name:RODRIGUEZ, RAMIRO (PT)
Entity type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7123 ROSSON LN APT 12
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1993
Mailing Address - Country:US
Mailing Address - Phone:210-849-4838
Mailing Address - Fax:
Practice Address - Street 1:6801 MCPHERSON RD STE 101
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6403
Practice Address - Country:US
Practice Address - Phone:956-721-0200
Practice Address - Fax:956-717-1677
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1400269225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist