Provider Demographics
NPI:1851852073
Name:RODRIGUEZ, EFRAIN
Entity type:Individual
Prefix:
First Name:EFRAIN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S SHARY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-1010
Mailing Address - Country:US
Mailing Address - Phone:956-583-0300
Mailing Address - Fax:956-583-0320
Practice Address - Street 1:201 S SHARY RD STE 100
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-1010
Practice Address - Country:US
Practice Address - Phone:956-583-0300
Practice Address - Fax:956-583-0320
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXT5015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program