Provider Demographics
NPI:1588129076
Name:RODRIGUEZ, MARIA ISABELL
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ISABELL
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 WEST LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-1446
Mailing Address - Country:US
Mailing Address - Phone:254-245-7546
Mailing Address - Fax:
Practice Address - Street 1:1511 WEST LN
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-1446
Practice Address - Country:US
Practice Address - Phone:254-245-7546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant