Provider Demographics
NPI:1700932019
Name:RODRIGUEZ GARCIA, DENISE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:RODRIGUEZ GARCIA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1901 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-2956
Mailing Address - Country:US
Mailing Address - Phone:956-542-8504
Mailing Address - Fax:956-542-6510
Practice Address - Street 1:871 OLD ALICE RD
Practice Address - Street 2:SUITE 600
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8268
Practice Address - Country:US
Practice Address - Phone:956-541-2102
Practice Address - Fax:956-541-2502
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3828048Medicaid
TX100816OtherLICENSE