MEDICARE: RICARDO RODRIGUEZ MTL

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	225X00000X	Occupational Therapist	MT128385	TX

General Provider Information

NPI Number	:	1518537430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICARDO RODRIGUEZ MTL

Provider Business Mailing Address
First Line	:	7909 HILLCROFT ST STE N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-7209
Country	:	US
Telephone Number	:	832-582-5631
Fax Number	:

Provider Business Practice Location Address
First Line	:	7909 HILLCROFT ST STE N
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-7209
Country	:	US
Telephone Number	:	832-582-5631
Fax Number	:

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

Provider Enumeration Date	:	07/01/2021
Last Update Date	:	07/01/2021

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Directions to “ RICARDO RODRIGUEZ MTL” Practice Location

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