Provider Demographics
NPI:1447541933
Name:RODRIGUEZ, ANTONIO JR (CSFA, CST)
Entity type:Individual
Prefix:MR
First Name:ANTONIO
Middle Name:
Last Name:RODRIGUEZ
Suffix:JR
Gender:M
Credentials:CSFA, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7827 JUNO HTS
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2772
Mailing Address - Country:US
Mailing Address - Phone:210-722-2606
Mailing Address - Fax:
Practice Address - Street 1:7827 JUNO HTS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78252-2772
Practice Address - Country:US
Practice Address - Phone:210-722-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant