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NPI Code Detail

MEDICARE: ROY RODRIGUEZ LMSW

MEDICARE: ROY RODRIGUEZ LMSW
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
1104100000XSocial Worker69392TX
21041S0200XSchool Social Worker69392TX

General Provider Information

NPI Number : 1225798333
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROY RODRIGUEZ LMSW
Provider Business Mailing Address
First Line : 15444 YARBERRY DR
Second Line :
City : ROANOKE
State : TX
Zip : 76262-3351
Country : US
Telephone Number : 956-358-0657
Fax Number :
Provider Business Practice Location Address
First Line : 1400 N CORINTH ST
Second Line :
City : CORINTH
State : TX
Zip : 76208-5444
Country : US
Telephone Number : 940-448-0304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2021
Last Update Date : 12/30/2021

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Directions to “ ROY RODRIGUEZ LMSW” Practice Location

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