Provider Demographics
NPI:1871599449
Name:RODRIGUEZ, ANA IRIS (MD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:IRIS
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9969 FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4106
Mailing Address - Country:US
Mailing Address - Phone:210-690-2273
Mailing Address - Fax:210-581-8209
Practice Address - Street 1:9969 FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4106
Practice Address - Country:US
Practice Address - Phone:210-690-2273
Practice Address - Fax:210-581-8209
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3709207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117540803Medicaid
2044227OtherAETNA
737807OtherHUMANA/GOLD
7754082002OtherCIGNA POS
7754082003OtherCIGNA HMO
161670005OtherPACIFICARE
85277YOtherBCBS
859795OtherONE HEALTH
3387591OtherBLUELINK
7754082003OtherCIGNA HMO
TX8965J8Medicare ID - Type Unspecified