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General NPI Number Information
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NPI Number | 1942568324
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Entity Type | Individual
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Provider Name | EVA L RODRIGUEZ
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 07/17/2015
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Provider Practice Location Address
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Address Line | 14636 S FM 2790 W SUITE 4
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City | LYTLE
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State | TX
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Zip | 78052-4540
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Country | US
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Telephone | 210-681-0603
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Fax | 210-681-3992
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Provider Business Mailing Address
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Address Line | 19775 BRUCE ST
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City | LYTLE
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State | TX
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Zip | 78052-3421
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Country | US
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Telephone | 210-681-0603
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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 | 341600000X
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Taxonomy Name | Ambulance
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License Number | 1000732
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License Number State | TX
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