Individual provider Active NPI

David Anthony Rodriguez Jr., M.D.

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1407177124
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
Q4504 Issued in TX
Practice address
5210 Thousand Oaks Dr
San Antonio, TX 78233-6974
Phone
(210) 261-4416
Fax
(210) 261-1833
NPI assigned
Jun 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X Q4504 TX
Psychiatry Physician 2084P0800X Q4504 TX Primary

Addresses

Primary practice location

5210 Thousand Oaks Dr
San Antonio, TX 78233-6974

Mailing address

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293
Phone (210) 261-1060

Other practice location 1

8535 Tom Slick
San Antonio, TX 78229-3367
Phone (210) 582-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150820010660 TX Practitioner - Psychiatry 1052626967 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at San Antonio, 2015
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13601 Marigold Rd
Plainfield, IL 60544-1929

6526 Charles FLD
San Antonio, TX 78238-3022

6800 Park Ten Blvd
San Antonio, TX 78213-4293

8431 Fredericksburg Rd
FL 5
San Antonio, TX 78229-3392

8535 Tom Slick
San Antonio, TX 78229-3367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
Q4504TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at San Antonio Current Accepting new patients
The University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2022 Accepting new patients
University of Texas Health Science Center at San Antonio CurrentSince Jul 1, 2022 Accepting new patients
Progressive Behavioral Health, PLLC Psychiatry CurrentSince Feb 22, 2024 Accepting new patients

Locations

3000 Polar Ln
Ste 101
Cedar Park, TX 78613
Phone (512) 201-4006

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

1425 Greenway Dr
Ste 360
Irving, TX 75038
Phone (317) 362-3417

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

7810 Louis Pasteur Dr
Fl 1
San Antonio, TX 78229
Phone (210) 450-7222

7703 Floyd Curl Dr
San Antonio, TX 78229
Phone (210) 450-3700

8535 Tom Slick
San Antonio, TX 78229
Phone (210) 582-6440

430 W Sunset Rd
Ste 400
San Antonio, TX 78209
Phone (210) 858-9078

4242 Medical Dr
Ste 6300
San Antonio, TX 78229
Phone (210) 614-8400

431 E State Highway 114
Ste 140
Southlake, TX 76092
Phone (817) 751-7802

Interoperability endpoints

  • Direct secure messaging: drodriguez35120@direct.utmsa.com
  • Direct secure messaging: lifestancehealth.davidrodriguez@136732.advancedmd-direct.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1407177124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6800 PARK TEN BLVD STE 200S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782134293",
            "telephone_number": "210-261-1060",
            "fax_number": "210-261-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5210 THOUSAND OAKS DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782336974",
            "telephone_number": "210-261-4416",
            "fax_number": "210-261-1833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8535 Tom Slick",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782293367",
            "country_code": "US",
            "telephone_number": "210-582-6440",
            "fax_number": "210-692-9021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DAVID",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "Q4504",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "Q4504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.