MEDICARE: MRS. MARTHA P 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	363A00000X	Physician Assistant	PA10549	TX

General Provider Information

NPI Number	:	1780037978
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARTHA P RODRIGUEZ PA-C

Provider Business Mailing Address
First Line	:	857 E WASHINGTON ST STE G
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-5939
Country	:	US
Telephone Number	:	956-541-2600
Fax Number	:	956-541-9202

Provider Business Practice Location Address
First Line	:	857 E WASHINGTON ST STE G
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-5939
Country	:	US
Telephone Number	:	956-541-2600
Fax Number	:	956-541-9202

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

Provider Enumeration Date	:	07/22/2016
Last Update Date	:	12/05/2025

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