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General NPI Number Information
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NPI Number | 1487306056
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Entity Type | Individual
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Provider Name | LUIS RENE RODRIGUEZ PHARMD, RPH
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Gender | Male
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Dates
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Enumeration Date | 01/24/2022
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 1736 N GREENVILLE AVE
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City | RICHARDSON
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State | TX
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Zip | 75081-1808
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Country | US
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Telephone | 888-501-0233
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Fax |
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Provider Business Mailing Address
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Address Line | 220 SANTA FE TRL APT 1086
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City | IRVING
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State | TX
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Zip | 75063-7107
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Country | US
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Telephone | 469-644-9438
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 69467
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License Number State | TX
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