MEDICARE: DAVID RODRIGUEZ L.P.C.

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	101Y00000X	Counselor	12433	TX

General Provider Information

NPI Number	:	1841946886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID RODRIGUEZ L.P.C.

Provider Business Mailing Address
First Line	:	109 IRONGATE RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2617
Country	:	US
Telephone Number	:	210-884-1851
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 IRONGATE RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2617
Country	:	US
Telephone Number	:	210-884-1851
Fax Number	:

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

Provider Enumeration Date	:	02/28/2022
Last Update Date	:	02/28/2022

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