Healthcare Provider Details

I. General information

NPI: 1962235663
Provider Name (Legal Business Name): SAUL RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W MEDICAL CENTER BLVD
WEBSTER TX
77598-4234
US

IV. Provider business mailing address

10512 ASHRIDGE DR
EL PASO TX
79925-7805
US

V. Phone/Fax

Practice location:
  • Phone: 281-316-0121
  • Fax: 281-316-0122
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: