MEDICARE: RAUL FRANCISCO RODRIGUEZ CRNA

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	367500000X	Certified Registered Nurse Anesthetist	704712	TX

General Provider Information

NPI Number	:	1326310228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL FRANCISCO RODRIGUEZ CRNA

Provider Business Mailing Address
First Line	:	3245 TOMAHAWK ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2315
Country	:	US
Telephone Number	:	915-920-8433
Fax Number	:

Provider Business Practice Location Address
First Line	:	3245 TOMAHAWK ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-2315
Country	:	US
Telephone Number	:	915-920-8433
Fax Number	:

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

Provider Enumeration Date	:	02/08/2012
Last Update Date	:	02/08/2012

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