Provider Demographics
NPI:1073168183
Name:ANAGNOSTOPOULOS, RENEE STAPLETON (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:STAPLETON
Last Name:ANAGNOSTOPOULOS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:RENEE
Other - Middle Name:ALAIA
Other - Last Name:STAPLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 WORTHSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-6438
Mailing Address - Country:US
Mailing Address - Phone:704-578-0878
Mailing Address - Fax:
Practice Address - Street 1:373 1/2 W 19TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3946
Practice Address - Country:US
Practice Address - Phone:713-714-4650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107256235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist