Healthcare Provider Details

I. General information

NPI: 1346237401
Provider Name (Legal Business Name): MICHAEL S RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 NORTH LOOP W SUITE 820
HOUSTON TX
77008-1664
US

IV. Provider business mailing address

1415 NORTH LOOP W SUITE 820
HOUSTON TX
77008-1664
US

V. Phone/Fax

Practice location:
  • Phone: 713-861-8200
  • Fax: 713-861-8261
Mailing address:
  • Phone: 713-861-8200
  • Fax: 713-861-8261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberL 1721
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: