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General NPI Number Information
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NPI Number | 1932966421
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Entity Type | Individual
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Provider Name | JAYMIE LEE RODRIGUEZ LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 1015 COLT
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City | LA FERIA
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State | TX
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Zip | 78559-5170
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Country | US
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Telephone | 956-336-9177
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 S 5TH ST APT 633
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City | TEMPLE
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State | TX
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Zip | 76502-3323
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Country | US
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Telephone | 956-336-9177
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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 | AT9836
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License Number State | TX
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