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NPI Code Detail

MEDICARE: CHRIS RODRIGUEZ CST

MEDICARE: CHRIS RODRIGUEZ CST
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
1246ZS0410XSurgical Technologist83055TX

General Provider Information

NPI Number : 1205952207
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRIS RODRIGUEZ CST
Provider Business Mailing Address
First Line : 871 CAPE CORAL CT
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-6383
Country : US
Telephone Number : 281-538-8489
Fax Number : 281-538-8979
Provider Business Practice Location Address
First Line : 871 CAPE CORAL CT
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-6383
Country : US
Telephone Number : 281-538-8489
Fax Number : 281-538-8979
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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