MEDICARE: JOSELITA D RODRIGUEZ MD

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	208000000X	Pediatrics Physician	F6096	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689692931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSELITA D RODRIGUEZ MD

Provider Business Mailing Address
First Line	:	2727 BOLTON BOONE DR STE 111
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2019
Country	:	US
Telephone Number	:	972-298-1878
Fax Number	:	972-298-1952

Provider Business Practice Location Address
First Line	:	2727 BOLTON BOONE DR STE 111
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-2019
Country	:	US
Telephone Number	:	972-298-1878
Fax Number	:	972-298-1952

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/21/2023

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