Provider Demographics
NPI:1992144414
Name:RODRIGUEZ VARGAS, EMMANUEL (MD)
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:
Last Name:RODRIGUEZ VARGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:EMMANUEL
Other - Middle Name:
Other - Last Name:RODRIGUEZ VARGAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2116 PARK PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-3908
Mailing Address - Country:US
Mailing Address - Phone:512-986-0257
Mailing Address - Fax:
Practice Address - Street 1:7800 SHOAL CREEK BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1098
Practice Address - Country:US
Practice Address - Phone:512-323-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA143057207R00000X
TXR4895207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine