Search › Texas › 122300000X
Ethan Roderick
NPI 1780518340 · on the registry since 2026
Practice
- Address
- 1100 Wilford Hall Loop
Jbsa Lackland, TX 78236 - Phone
- (210) 292-4277
- Clinicians at this address
- 599
Additional practice sites
- 3551 Roger Brooke Dr, Fort Sam Houston, TX
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Licence states on file
- NM
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-07-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas