Active NPI
Klade Dane Rodriguez
- Student in an Organized Health Care Education/Training Program
- College Station, TX
National Provider Identifier
1740647486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 36849484
- Practice address
- 200 Marion Pugh Dr Apt 104
College Station, TX 77840-2702 - Phone
- (254) 316-8275
- NPI assigned
- Jan 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 36849484 | TX | Primary |
Addresses
Primary practice location
200 Marion Pugh Dr Apt 104
College Station, TX 77840-2702
Mailing address
P.O. Box 22
Satin, TX 76685
Phone (254) 316-8275
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 |
|---|---|---|---|
| 36849484 | TX | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453766400000",
"number": "1740647486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P.O. BOX 22",
"city": "SATIN",
"state": "TX",
"postal_code": "76685",
"telephone_number": "254-316-8275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MARION PUGH DR APT 104",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778402702",
"telephone_number": "254-316-8275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "KLADE",
"middle_name": "DANE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-01-26",
"last_updated": "2016-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "TX",
"license": "36849484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in College Station, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.