MEDICARE: MELINDA RODRIGUEZ BARRERA

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	164X00000X	Licensed Vocational Nurse	303936	TX

General Provider Information

NPI Number	:	1023599354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA RODRIGUEZ BARRERA

Provider Business Mailing Address
First Line	:	4406 WILDT RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-1128
Country	:	US
Telephone Number	:	210-269-0555
Fax Number	:

Provider Business Practice Location Address
First Line	:	4406 WILDT RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-1128
Country	:	US
Telephone Number	:	210-269-0555
Fax Number	:

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

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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Directions to “ MELINDA RODRIGUEZ BARRERA ” Practice Location

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