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General NPI Number Information
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NPI Number | 1295132827
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Entity Type | Organization
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Legal Business Name | VICTOR RODRIGUEZ DDS, PA
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 17225 EL CAMINO REAL #150
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City | HOUSTON
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State | TX
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Zip | 77058-2700
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Country | US
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Telephone | 281-280-9380
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Fax | 281-280-9376
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Provider Business Mailing Address
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Address Line | 17225 EL CAMINO REAL #150
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City | HOUSTON
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State | TX
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Zip | 77058-2700
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Country | US
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Telephone | 281-280-9380
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Fax | 281-280-9376
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Authorized Official
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Title or Position | DENTIST
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Name | MR. VICTOR RODRIGUEZ
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Credential | DDS
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Telephone | 281-280-9380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 18149
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License Number State | TX
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