{
"Npi": {
"NPI": "1982868873",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RODRIGUEZ",
"FirstName": "JAIRO",
"MiddleName": "ALEJANDRO",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PA-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2657 WINDMILL PKWY",
"SecondLineMailingAddress": "PMB 136",
"MailingAddressCityName": "HENDERSON",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89074",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-277-2370",
"MailingAddressFaxNumber": "702-442-1870",
"FirstLinePracticeLocationAddress": "10422 RESEARCH FOREST DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MAGNOLIA",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77354-6155",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "832-702-7699",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/10/2008",
"LastUpdateDate": "02/14/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "M",
"Gender": "Male",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "10004417A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AS0400X",
"TaxonomyName": "Surgical Physician Assistant",
"LicenseNumber": "PA1120",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "50008732RX",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "10168927-1206",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "085010435",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA59805",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "PA9117251",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "012535",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "7794-23",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "PA1120",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "OA006808",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "363A00000X",
"TaxonomyName": "Physician Assistant",
"LicenseNumber": "PA16208",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "5601012208",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}