MEDICARE: RODRIGUEZ MEDICAL MANAGEMENT

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	207R00000X	Internal Medicine Physician
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1598501165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RODRIGUEZ MEDICAL MANAGEMENT

Provider Business Mailing Address
First Line	:	15825 BELLAIRE BLVD STE I
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2347
Country	:	US
Telephone Number	:	281-560-4968
Fax Number	:	832-328-1912

Provider Business Practice Location Address
First Line	:	15825 BELLAIRE BLVD STE I
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-2347
Country	:	US
Telephone Number	:	281-560-4968
Fax Number	:	832-328-1912

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JULIO C RODRIGUEZ
Credential	:	MD
Telephone Number	:	281-414-0930

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	10/14/2024

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