MEDICARE: HENRY N RODRIGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	1000154	TX

General Provider Information

NPI Number	:	1023264579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY N RODRIGUEZ

Provider Business Mailing Address
First Line	:	PO BOX 544
Second Line	:
City	:	LYFORD
State	:	TX
Zip	:	78569-0544
Country	:	US
Telephone Number	:	956-299-0115
Fax Number	:

Provider Business Practice Location Address
First Line	:	7882 BUSINESS 77
Second Line	:
City	:	LYFORD
State	:	TX
Zip	:	78569
Country	:	US
Telephone Number	:	956-299-0115
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	03/12/2009

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Directions to “ HENRY N RODRIGUEZ ” Practice Location

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