Octavio J. Rodriguez, Md | |
1021 Senator Carlos Truan Blvd Kingsville TX 78363-6667 | |
(361) 595-5556 | |
(361) 595-0295 |
Full Name | Octavio J. Rodriguez, Md |
---|---|
Speciality | Family Medicine |
Location | 1021 Senator Carlos Truan Blvd, Kingsville, Texas |
Authorized Official Name and Position | Octavio Javier Rodriguez (M.D.) |
Authorized Official Contact | 3615955556 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Octavio J. Rodriguez, Md Po Box 1597 Kingsville TX 78364-1597 Ph: (361) 595-5556 | Octavio J. Rodriguez, Md 1021 Senator Carlos Truan Blvd Kingsville TX 78363-6667 Ph: (361) 595-5556 |
NPI Number | 1619097797 |
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Provider Enumeration Date | 03/30/2007 |
Last Update Date | 08/19/2022 |
Medicare PECOS PAC ID | 0042495012 |
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Medicare Enrollment ID | O20110506000540 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619097797 | NPI | - | NPPES |
130853801 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Octavio J Rodriguez |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1619074929 PECOS PAC ID: 4284788431 Enrollment ID: I20110506000556 |
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