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General NPI Number Information
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NPI Number | 1912897828
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Entity Type | Individual
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Provider Name | JONATHAN RODRIGUEZ
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Gender | Male
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Dates
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Enumeration Date | 07/03/2025
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 1022 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-2400
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Country | US
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Telephone | 956-600-7123
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Fax |
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Provider Business Mailing Address
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Address Line | 1706 W GARRISON DR APT A
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City | PHARR
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State | TX
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Zip | 78577-0308
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Country | US
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Telephone | 956-204-7506
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 92229
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License Number State | TX
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