Healthcare Provider Details

I. General information

NPI: 1295154284
Provider Name (Legal Business Name): RODNEY LAGRONE JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 SAINT MICHAEL DR
TEXARKANA TX
75503-2372
US

IV. Provider business mailing address

6225 N STATE HIGHWAY 161 STE 200
IRVING TX
75038-2241
US

V. Phone/Fax

Practice location:
  • Phone: 903-614-5258
  • Fax:
Mailing address:
  • Phone: 214-687-0493
  • Fax: 146-879-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberR7796
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: