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General NPI Number Information
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NPI Number | 1205700481
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Entity Type | Individual
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Provider Name | ISAAC RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 901 S HUNTINGTON ST
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City | SULPHUR
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State | LA
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Zip | 70663-4419
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Country | US
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Telephone | 337-429-8088
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Fax | 337-347-6294
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Provider Business Mailing Address
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Address Line | 4411 SOMERSET ST
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City | LAKE CHARLES
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State | LA
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Zip | 70605-3933
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Country | US
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Telephone |
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Fax | 337-347-6294
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 213648
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License Number State | LA
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