Healthcare Provider Details

I. General information

NPI: 1700235959
Provider Name (Legal Business Name): BARBARA ANN RODRIGUEZ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2016
Last Update Date: 05/20/2024
Certification Date: 05/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1145 E COMMERCE ST STE 101
SAN ANTONIO TX
78205-3327
US

IV. Provider business mailing address

PO BOX 592318
SAN ANTONIO TX
78259-0165
US

V. Phone/Fax

Practice location:
  • Phone: 210-209-3043
  • Fax: 210-384-2582
Mailing address:
  • Phone: 210-209-3043
  • Fax: 210-384-2582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number017426
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number017426
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number017426
License Number StateTX

VIII. Authorized Official

Name: BARBARA RODRIGUEZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 210-417-4480