Provider Demographics
NPI:1538385224
Name:RODRIGUEZ, JOE HENRY (DC)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:HENRY
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 CORAL CAY LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-7240
Mailing Address - Country:US
Mailing Address - Phone:512-989-7330
Mailing Address - Fax:
Practice Address - Street 1:14735 BRATTON LN
Practice Address - Street 2:207
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78728-4568
Practice Address - Country:US
Practice Address - Phone:512-990-5121
Practice Address - Fax:512-990-5644
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8175111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor