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General NPI Number Information
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NPI Number | 1386142693
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Entity Type | Individual
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Provider Name | JEFFREY GABRIEL RODRIGUEZ II MS, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 02/01/2018
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Last Update Date | 02/01/2018
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Provider Practice Location Address
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Address Line | RICE UNIVERSITY, MS 548, 6100 S. MAIN ST.
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City | HOUSTON
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State | TX
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Zip | 77005-7700
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Country | US
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Telephone | 713-348-4739
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Fax | 713-348-5621
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Provider Business Mailing Address
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Address Line | 5353 INSTITUTE LN APT 39
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City | HOUSTON
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State | TX
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Zip | 77005-1887
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Country | US
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Telephone | 512-775-4890
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT6628
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License Number State | TX
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