MEDICARE: DR. MADELINE JULES RODRIGUEZ DDS

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	122300000X	Dentist	35552	TX

General Provider Information

NPI Number	:	1871147975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADELINE JULES RODRIGUEZ DDS

Provider Business Mailing Address
First Line	:	3949 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-3231
Country	:	US
Telephone Number	:	432-208-9731
Fax Number	:

Provider Business Practice Location Address
First Line	:	3949 FREDERICKSBURG RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-3231
Country	:	US
Telephone Number	:	432-208-9731
Fax Number	:

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

Provider Enumeration Date	:	07/26/2019
Last Update Date	:	06/17/2024

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