MEDICARE: ARMANDO RODRIGUEZ JR. AG-ACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	AP139499	TX
2	363LG0600X	Gerontology Nurse Practitioner	AP139499	TX
3	363L00000X	Nurse Practitioner	AP139499	TX

General Provider Information

NPI Number	:	1306317284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARMANDO RODRIGUEZ JR. AG-ACNP-BC

Provider Business Mailing Address
First Line	:	2000 S MCCOLL RD SUITE B #303
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-1516
Country	:	US
Telephone Number	:	956-215-6010
Fax Number	:	956-265-1027

Provider Business Practice Location Address
First Line	:	2000 S MCCOLL RD STE B
Second Line	:
City	:	MCALLEN
State	:	TX
Zip	:	78503-1516
Country	:	US
Telephone Number	:	956-215-6010
Fax Number	:

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

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	01/07/2019

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