Individual provider Active NPI

Gerardo Favian Rodriguez, MD

  • Family Medicine Physician
  • Denton, TX
National Provider Identifier
1629657390
Registry record updated Sep 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
V2561 Issued in TX
Practice address
4304 Mesa Dr
Denton, TX 76207-3434
Phone
(940) 381-1501
Fax
(940) 591-7830
NPI assigned
Apr 7, 2021
Last updated
Sep 23, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X V2561 TX Primary

Addresses

Primary practice location

4304 Mesa Dr
Denton, TX 76207-3434

Mailing address

1500 S Main St
Fort Worth, TX 76104-4917

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
I20241030002691 TX Practitioner - Family Practice 9234662198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Wisconsin School of Medicine, 2021
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

4304 Mesa Dr
Denton, TX 76207-3434
Phone (940) 381-1501

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V2561TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Services of North Texas, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Health Services of North Texas, Inc. Family Medicine CurrentSince Aug 19, 2024 Accepting new patients
Misalud, Inc. Past Accepting new patients

Locations

4304 Mesa Dr
Denton, TX 76207
Phone (502) 724-6044

4401 N Interstate 35
Unit 312
Denton, TX 76207

Organizations & group practices 3

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758585600000",
    "number": "1629657390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4304 MESA DR",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762073434",
            "telephone_number": "940-381-1501",
            "fax_number": "940-591-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "GERARDO",
        "middle_name": "FAVIAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-07",
        "last_updated": "2025-09-23",
        "certification_date": "2025-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "V2561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, TX

Sources for this page

Verify at the official NPI Registry.