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General NPI Number Information
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NPI Number | 1114252764
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Entity Type | Organization
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Legal Business Name | VICTOR M. RODRIGUEZ, M.D., MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 10/14/2009
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Provider Practice Location Address
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Address Line | 4126 SOUTHWEST FWY SUITE 520
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City | HOUSTON
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State | TX
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Zip | 77027-7310
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Country | US
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Telephone | 713-664-1918
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Fax | 713-664-2313
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Provider Business Mailing Address
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Address Line | 42 LAKE MIST DR
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City | SUGAR LAND
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State | TX
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Zip | 77479-5860
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Country | US
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Telephone | 713-664-1918
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Fax | 713-664-2313
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTOR M RODRIGUEZ
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Credential | M.D.
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Telephone | 713-664-1918
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K1030
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License Number State | TX
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