MEDICARE: DR. MARGOT BAZAN RODRIGUEZ M.D.

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	174400000X	Specialist	F8306	TX

General Provider Information

NPI Number	:	1992818769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGOT BAZAN RODRIGUEZ M.D.

Provider Business Mailing Address
First Line	:	2002 HOLCOMBE BLVD
Second Line	:	DEPARTMENT OF RADIOLOGY
City	:	HOUSTON
State	:	TX
Zip	:	77030-4211
Country	:	US
Telephone Number	:	713-791-1414
Fax Number	:

Provider Business Practice Location Address
First Line	:	1917 LAUDERDALE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-4105
Country	:	US
Telephone Number	:	713-799-8427
Fax Number	:

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

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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