Physician Compare National (NPI:1578511192)

HEALTHCARE PROVIDER: VIVIAN ODETTE RODRIGUEZ M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1578511192
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9739194119
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060207000801
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RODRIGUEZ
	Individual professional last name
Provider First Name	VIVIAN
	Individual professional first name
Provider Middle Name	ODETTE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2201 W HOLCOMBE BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 245
	Group Practice or individual's line 2 address
City	HOUSTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	770302032
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450193
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CHI BAYLOR ST LUKES MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450358
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOUSTON METHODIST HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450184
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HERMANN HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	450424
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	HOUSTON METHODIST SAN JACINTO HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	M