Provider Demographics
NPI:1871776633
Name:MARIA ELENA RODRIGUEZ, M.D. P.A.
Entity type:Organization
Organization Name:MARIA ELENA RODRIGUEZ, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ELENA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-380-1833
Mailing Address - Street 1:PO BOX 2429
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78540-2429
Mailing Address - Country:US
Mailing Address - Phone:956-380-1833
Mailing Address - Fax:956-380-6929
Practice Address - Street 1:3220 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-6666
Practice Address - Country:US
Practice Address - Phone:956-380-1833
Practice Address - Fax:956-380-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-14
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3457207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170892701Medicaid
TX170892701Medicaid