Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Myrna Cruz Roderick, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1366703852

Myrna Cruz Roderick, NURSEPRACTITIONER is a Nurse Practitioner in Beaumont, Texas. Qualified in 2005, 21 years ago. Practices with Diagnostic Group Integrated Healthcare System, PLLC, a 35-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
21
Licensed in
TX
In the registry since
2012
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Practice location Address checks out

6480 Delaware St
Beaumont, TX 77706-4648
Phone: (409) 813-1677
Fax: (409) 232-0596
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 722471 (TX)

Record details

NPI number1366703852
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedMay 31, 2012
Last updated in NPPESJune 11, 2024
Certification dateJune 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Diagnostic Group Integrated Healthcare System, Pllc — 35 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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