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General NPI Number Information
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NPI Number | 1073541223
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Entity Type | Individual
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Provider Name | NIDRA I RODRIGUEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 7000 FANNIN ST STE 750
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City | HOUSTON
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State | TX
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Zip | 77030-5400
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Country | US
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Telephone | 713-500-8360
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Fax | 713-500-8364
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Provider Business Mailing Address
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Address Line | 7000 FANNIN ST STE 700
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City | HOUSTON
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State | TX
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Zip | 77030-5400
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Country | US
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Telephone | 713-500-8345
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Fax | 713-500-8348
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | M2053
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2080P0207X
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Taxonomy Name | Pediatric Hematology & Oncology Physician
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License Number | M2053
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License Number State | TX
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