Provider Demographics
NPI:1992724090
Name:RODRIGUEZ, HECTOR (FNP)
Entity type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 E MAIN AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALTON
Mailing Address - State:TX
Mailing Address - Zip Code:78573-1561
Mailing Address - Country:US
Mailing Address - Phone:956-580-9950
Mailing Address - Fax:956-580-9953
Practice Address - Street 1:3509 E MAIN AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ALTON
Practice Address - State:TX
Practice Address - Zip Code:78573-1561
Practice Address - Country:US
Practice Address - Phone:956-580-9950
Practice Address - Fax:956-580-9953
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX631625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily