Healthcare Provider Details

I. General information

NPI: 1811577489
Provider Name (Legal Business Name): STEVEN CYRUS RODRIGUEZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2021
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 EVANS ST
UVALDE TX
78801-5142
US

IV. Provider business mailing address

908 EVANS ST STE A
UVALDE TX
78801-6052
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-7105
  • Fax: 830-278-1941
Mailing address:
  • Phone: 830-278-5604
  • Fax: 830-278-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV1875
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: