Healthcare Provider Details

I. General information

NPI: 1316903404
Provider Name (Legal Business Name): RICHARD AARON RODRIGUEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PALO ALTO RD SUITE 450
SAN ANTONIO TX
78211-3772
US

IV. Provider business mailing address

102 PALO ALTO RD STE 450
SAN ANTONIO TX
78211-3782
US

V. Phone/Fax

Practice location:
  • Phone: 210-922-0555
  • Fax:
Mailing address:
  • Phone: 210-922-0555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberF1946
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberF1946
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: