MEDICARE: MS. ALYSSA CALYSE 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	PA20014	TX

General Provider Information

NPI Number	:	1891488425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALYSSA CALYSE RODRIGUEZ PA-C

Provider Business Mailing Address
First Line	:	5301 DAVIS LN STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-4031
Country	:	US
Telephone Number	:	512-615-2730
Fax Number	:	512-666-3764

Provider Business Practice Location Address
First Line	:	5301 DAVIS LN STE 100
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-4031
Country	:	US
Telephone Number	:	512-615-2730
Fax Number	:	512-666-3764

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

Provider Enumeration Date	:	05/30/2023
Last Update Date	:	04/23/2026

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Directions to “ MS. ALYSSA CALYSE RODRIGUEZ PA-C” Practice Location

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