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General NPI Number Information
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NPI Number | 1124094628
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Entity Type | Individual
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Provider Name | EDGAR RODRIGUEZ M.D., M.P.H.
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Gender | Male
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Dates
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Enumeration Date | 02/24/2006
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 18511 HIGHLANDER MEDICS ST
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City | FORT BLISS
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State | TX
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Zip | 79906-5327
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Country | US
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Telephone | 575-674-3500
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Fax | 915-742-7459
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Provider Business Mailing Address
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Address Line | PO BOX 429
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City | ELEPHANT BUTTE
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State | NM
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Zip | 87935-0429
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Country | US
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Telephone | 210-213-2880
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11644
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2024-0814
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | 11644
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License Number State | PR
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Taxonomy #4
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | MD2024-0814
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | MD2024-0814
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License Number State | NM
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Taxonomy #6
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 11644
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License Number State | PR
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