Provider Demographics
NPI:1902077241
Name:DIPLAN RODRIGUEZ, MARIEL (MD)
Entity Type:Individual
Prefix:
First Name:MARIEL
Middle Name:
Last Name:DIPLAN RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3828 AVENUE N
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-6693
Mailing Address - Country:US
Mailing Address - Phone:409-761-3200
Mailing Address - Fax:409-761-3209
Practice Address - Street 1:3828 AVENUE N
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77550-6614
Practice Address - Country:US
Practice Address - Phone:409-761-3200
Practice Address - Fax:409-761-3209
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine