Active NPI
Juan M Rodriguez Jr.
- Technician
- Mission, TX
National Provider Identifier
1558039099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- License
- 200918
- Practice address
- 820 South Conway
Mission, TX 78574 - Phone
- (956) 581-2173
- NPI assigned
- Aug 31, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Technician | 374700000X | 200918 | TX | Primary |
Addresses
Primary practice location
820 South Conway
Mission, TX 78574
Mailing address
820 South Conway
Mission, TX 78574
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 |
|---|---|---|---|
| 200918 | TX | MD | Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630368000000",
"number": "1558039099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 SOUTH CONWAY",
"city": "MISSION",
"state": "TX",
"postal_code": "78574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 SOUTH CONWAY",
"city": "MISSION",
"state": "TX",
"postal_code": "78574",
"telephone_number": "956-581-2173"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JUAN",
"middle_name": "M",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-31",
"last_updated": "2021-08-31",
"certification_date": "2021-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": "TX",
"license": "200918",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.