Active NPI
Samuel Rodriguez, LSA
- Surgical Physician Assistant
- Houston, TX
National Provider Identifier
1912125394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 11106 Barrow LN
Houston, TX 77065-5252 - Phone
- (713) 582-2011
- NPI assigned
- Apr 23, 2007
- 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
11106 Barrow LN
Houston, TX 77065-5252
Mailing address
PO Box 691564
Houston, TX 77269-1564
Phone (281) 653-2924
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SA0187 | Other | TX | GENERAL SURGERY |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gpe Surgical Inc. | Surgical Assistant | Current | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641945600000",
"number": "1912125394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 691564",
"city": "HOUSTON",
"state": "TX",
"postal_code": "772691564",
"telephone_number": "281-653-2924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11106 BARROW LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770655252",
"telephone_number": "713-582-2011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "SAMUEL",
"name_prefix": "Mr.",
"credential": "LSA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-23",
"last_updated": "2022-01-12",
"certification_date": "2022-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GENERAL SURGERY",
"identifier": "SA0187",
"state": "TX"
}
],
"endpoints": [],
"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 Jan 12, 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.