MEDICARE: CHRISTOPHER RODRIGUEZ APRN

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	363LF0000X	Family Nurse Practitioner	AP130890	TX
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP130890	TX

General Provider Information

NPI Number	:	1902252687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER RODRIGUEZ APRN

Provider Business Mailing Address
First Line	:	8620 N NEW BRAUNFELS AVE STE 515
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-6360
Country	:	US
Telephone Number	:	210-239-8269
Fax Number	:	844-898-6214

Provider Business Practice Location Address
First Line	:	900 NE LOOP 410 STE D-215
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209-1410
Country	:	US
Telephone Number	:	210-239-8269
Fax Number	:	844-898-6214

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

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	02/25/2024

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