MEDICARE: MRS. AMANDA RODRIGUEZ PA-C

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	363AM0700X	Medical Physician Assistant	PA08667	TX

General Provider Information

NPI Number	:	1477983674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMANDA RODRIGUEZ PA-C

Provider Business Mailing Address
First Line	:	1251 LONG GATE
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3779
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1251 LONG GATE
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-3779
Country	:	US
Telephone Number	:	830-221-6766
Fax Number	:

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

Provider Enumeration Date	:	11/25/2013
Last Update Date	:	01/08/2026

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