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NPI Code Detail

MEDICARE: JESSICA RODRIGUEZ P.T.

MEDICARE: JESSICA RODRIGUEZ P.T.
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
1225100000XPhysical Therapist1169500TX

General Provider Information

NPI Number : 1275641292
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA RODRIGUEZ P.T.
Provider Business Mailing Address
First Line : 7430 REMCON CIR
Second Line : STE. B110
City : EL PASO
State : TX
Zip : 79912-3514
Country : US
Telephone Number : 915-544-2455
Fax Number : 915-544-3149
Provider Business Practice Location Address
First Line : 9870 GATEWAY BLVD N
Second Line : STE. B7
City : EL PASO
State : TX
Zip : 79924-4425
Country : US
Telephone Number : 915-751-5245
Fax Number : 915-751-5255
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2006
Last Update Date : 09/06/2007

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