Healthcare Provider Details

I. General information

NPI: 1730282765
Provider Name (Legal Business Name): MELINDA AGPAOA RODRIGUEZ PT,DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E. SONTERRA BLVD. SUITE 601
SAN ANTONIO TX
78258-4291
US

IV. Provider business mailing address

23702 JENKINS HILL
SAN ANTONIO TX
78255-9539
US

V. Phone/Fax

Practice location:
  • Phone: 210-724-4296
  • Fax: 210-349-0097
Mailing address:
  • Phone: 210-724-4296
  • Fax: 210-349-0097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1069730
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: