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General NPI Number Information
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NPI Number | 1023488988
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Entity Type | Individual
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Provider Name | CHRISTANIE RODRIGUEZ M.S, ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 10/03/2015
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 3410 TAFT BLVD D.L LIGON COLISEUM 158
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2036
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Country | US
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Telephone | 940-397-4815
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Fax | 940-397-4901
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Provider Business Mailing Address
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Address Line | 3410 TAFT BLVD D.L LIGON COLISEUM 158
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2036
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Country | US
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Telephone | 940-397-4815
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Fax | 940-397-4901
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT4493
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License Number State | TX
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