MEDICARE: MICHELLE 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	207Q00000X	Family Medicine Physician	S0370	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316300023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE RODRIGUEZ

Provider Business Mailing Address
First Line	:	903 W MARTIN ST # MS 49-2
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-0903
Country	:	US
Telephone Number	:	210-358-5909
Fax Number	:

Provider Business Practice Location Address
First Line	:	19780 S US HIGHWAY 281
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-9761
Country	:	US
Telephone Number	:	210-626-0600
Fax Number	:	210-626-1174

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	12/19/2025

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Directions to “ MICHELLE RODRIGUEZ ” Practice Location

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