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General NPI Number Information
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NPI Number | 1023827920
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Entity Type | Individual
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Provider Name | JAVIER ALFONSO RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 01/06/2025
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 11330 FARRAH
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City | AUSTIN
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State | TX
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Zip | 78748-1959
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Country | US
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Telephone | 512-280-2030
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Fax |
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Provider Business Mailing Address
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Address Line | 25399 THE OLD RD APT 14203
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City | STEVENSON RANCH
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State | CA
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Zip | 91381-1628
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Country | US
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Telephone | 805-276-2780
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 125268
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License Number State | TX
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