Othon Rodriguez

Individual provider Active NPI Case Manager/Care Coordinator · Portales, NM

NPI 1992117337 · NPPES record last updated Mar 23, 2015

Key facts

NPI
1992117337
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1111 W. Fir
Portales, NM 88130
Phone
(575) 356-5112
NPI assigned
May 20, 2014
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1111 W. Fir
Portales, NM 88130

Mailing address

1100 W. 21St Street
Clovis, NM 88101
Phone (575) 769-2345

Other providers in Portales, NM

All providers in Portales, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.