Provider Demographics
NPI:1861102360
Name:RODRIGUEZ SPEECH & THERAPY CENTER
Entity type:Organization
Organization Name:RODRIGUEZ SPEECH & THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:LIZETTE
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:956-572-6854
Mailing Address - Street 1:5462 PEPPERMILL RUN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-4314
Mailing Address - Country:US
Mailing Address - Phone:956-572-6854
Mailing Address - Fax:
Practice Address - Street 1:3040 RUBEN TORRES SR BLVD STE B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-2871
Practice Address - Country:US
Practice Address - Phone:956-572-6854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-25
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty