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General NPI Number Information
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NPI Number | 1013554500
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Entity Type | Individual
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Provider Name | ERIC MATTHEW RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 7939 PAT BOOKER RD STE 120
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City | LIVE OAK
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State | TX
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Zip | 78233-2776
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Country | US
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Telephone | 210-660-2345
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Fax | 210-446-1442
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Provider Business Mailing Address
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Address Line | PO BOX 306393
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City | NASHVILLE
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State | TN
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Zip | 37230-6393
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Country | US
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Telephone | 615-373-1350
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Fax | 615-221-9054
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 00000
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License Number State |
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