Healthcare Provider Details
I. General information
NPI: 1326284514
Provider Name (Legal Business Name): LUIS JAVIER RODRIGUEZ FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/18/2008
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
26103 GLENBRIAR SPRING LN
CYPRESS TX
77433-1355
US
IV. Provider business mailing address
26103 GLENBRIAR SPRING LN
CYPRESS TX
77433-1355
US
V. Phone/Fax
- Phone: 281-256-2359
- Fax:
- Phone: 281-256-2359
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 202106694NP-PP |
| License Number State | OR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | 69242 |
| License Number State | NM |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 601953 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: