MEDICARE: IRISTELA RODRIQUEZ LMFT

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	101YP2500X	Professional Counselor	76559	TX
2	106H00000X	Marriage & Family Therapist	5151	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	8606BH	OTHER	TX	BCBS OF TX

General Provider Information

NPI Number	:	1336192426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IRISTELA RODRIQUEZ LMFT

Provider Business Mailing Address
First Line	:	4502 RIVERSTONE BLVD STE 902
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5206
Country	:	US
Telephone Number	:	281-778-8750
Fax Number	:	281-778-8751

Provider Business Practice Location Address
First Line	:	4502 RIVERSTONE BLVD STE 902
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-5206
Country	:	US
Telephone Number	:	281-778-8750
Fax Number	:	281-778-8751

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

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	09/08/2025

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