MEDICARE: DR. LIA C RODRIGUEZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	ME98737	FL
2	208000000X	Pediatrics Physician	N1864	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013122944
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIA C RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	2450 HOLCOMBE BLVD
Second Line	:	SUITE 34L , NB-8391
City	:	HOUSTON
State	:	TX
Zip	:	77021-2039
Country	:	US
Telephone Number	:	832-828-1583
Fax Number	:	832-825-8705

Provider Business Practice Location Address
First Line	:	2450 HOLCOMBE BLVD
Second Line	:	SUITE 34L , NB-8391
City	:	HOUSTON
State	:	TX
Zip	:	77021-2039
Country	:	US
Telephone Number	:	832-828-1583
Fax Number	:	832-825-8705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	11/19/2015

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Directions to “ DR. LIA C RODRIGUEZ M.D.” Practice Location

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