Basic Information
| Provider Information | |||||||||
| NPI: | 1285727206 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1860 S SEGUIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781303913 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104487700 | ||||||||
| FaxNumber: | 2104487703 | ||||||||
| Practice Location | |||||||||
| Address1: | 1860 S SEGUIN AVE | ||||||||
| Address2: | |||||||||
| City: | NEW BRAUNFELS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781303914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104487700 | ||||||||
| FaxNumber: | 2104487703 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 02/09/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | J8359 | TX | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | J8359 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 039791107 | 05 | TX | MEDICAID | 039791108 | 05 | TX | MEDICAID | 8CU825 | 01 | TX | BCBS | OTHER |