Active NPI
Graciela Rodriguez, DDS
- Dentist
- Houston, TX
National Provider Identifier
1487809299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 24146
- Practice address
- 15634 Wallisville Rd Ste 900
Houston, TX 77049-4636 - Phone
- (281) 864-5073
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 24146 | TX | |
| Dentist | 122300000X | 24146 | TX | Primary |
Addresses
Primary practice location
15634 Wallisville Rd Ste 900
Houston, TX 77049-4636
Mailing address
15634 Wallisville Rd Ste 900
Houston, TX 77049-4636
Phone (281) 864-5073
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487809299 | Medicaid | TX |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | info@mosaicdentaltx.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24146 | TX | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1487809299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15634 WALLISVILLE RD STE 900",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770494636",
"telephone_number": "281-864-5073",
"fax_number": "281-864-5075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15634 WALLISVILLE RD STE 900",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770494636",
"telephone_number": "281-864-5073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "GRACIELA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-20",
"last_updated": "2022-10-24",
"certification_date": "2022-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "24146",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "24146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1487809299",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "info@mosaicdentaltx.com",
"affiliation": "N",
"endpointDescription": "Office email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "office email",
"address_1": "15634 Wallisville Rd Ste 900",
"city": "Houston",
"state": "TX",
"country_code": "US",
"postal_code": "770494636",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.