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General NPI Number Information
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NPI Number | 1013761261
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Entity Type | Individual
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Provider Name | YAQUELIN ALONSO RODRIGUEZ DMD
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 06/19/2024
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Provider Practice Location Address
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Address Line | 3030 LBJ FWY STE 1700
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City | DALLAS
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State | TX
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Zip | 75234-2759
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Country | US
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Telephone | 832-600-8482
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Fax |
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Provider Business Mailing Address
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Address Line | 30222 INDIGO FALLS DR
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City | BROOKSHIRE
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State | TX
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Zip | 77423-2918
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Country | US
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Telephone | 832-600-8482
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 40517
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License Number State | TX
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