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General NPI Number Information
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NPI Number | 1710543608
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Entity Type | Organization
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Legal Business Name | DR. RICARDO RODRIGUEZ O.D. VISION & ASSOC. PLLC
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 1400 PRECINCT LINE RD
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City | HURST
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State | TX
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Zip | 76053-3828
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Country | US
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Telephone | 818-854-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 5225 LAS COLINAS BLVD APT 4060
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City | IRVING
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State | TX
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Zip | 75039-4581
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Country | US
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Telephone | 818-854-5651
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RICARDO RODRIGUEZ
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Credential | O.D.
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Telephone | 818-854-5651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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