Active NPI
Jeffrey Rodriguez
- Medical Laboratory Technician
- El Paso, TX
National Provider Identifier
1710741285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Laboratory Technician
- License
- 2317
- Practice address
- 11140 La Quinta PL Ste 101B
El Paso, TX 79936-5227 - Phone
- (915) 494-2611
- NPI assigned
- Feb 6, 2024
- 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 |
|---|---|---|---|---|
| Medical Laboratory Technician | 246RM2200X | 2317 | TX | Primary |
Addresses
Primary practice location
11140 La Quinta PL Ste 101B
El Paso, TX 79936-5227
Mailing address
11140 La Quinta PL # 101B
El Paso, TX 79936-5227
Phone (915) 494-2611
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 |
|---|---|---|---|
| 2317 | TX | MD | Medical Laboratory Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proline Labs | Current | Accepting new patients |
Locations
11140 La Quinta Pl
#101B
El Paso, TX 79936
Phone (915) 494-2611
11140 La Quinta Pl
Ste 101B
El Paso, TX 79936
Phone (915) 262-4300
1387 George Dieter Dr
Ste D105
El Paso, TX 79936
Phone (512) 994-7700
Organizations & group practices 1
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.
-
- Clinical Medical Laboratory
- El Paso, TX
- NPI 1427812916
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722816000000",
"number": "1710741285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11140 LA QUINTA PL # 101B",
"city": "EL PASO",
"state": "TX",
"postal_code": "799365227",
"telephone_number": "915-494-2611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11140 LA QUINTA PL STE 101B",
"city": "EL PASO",
"state": "TX",
"postal_code": "799365227",
"telephone_number": "915-494-2611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-06",
"last_updated": "2024-08-05",
"certification_date": "2024-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "TX",
"license": "2317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.