Provider Demographics
NPI:1093047342
Name:RODGERS SPEECH, HEARING & EDUCATIONAL SERVICES, PLLC
Entity Type:Organization
Organization Name:RODGERS SPEECH, HEARING & EDUCATIONAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:YVETTE
Authorized Official - Last Name:RODGERS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:254-526-8255
Mailing Address - Street 1:1133 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76704-2651
Mailing Address - Country:US
Mailing Address - Phone:254-235-5084
Mailing Address - Fax:254-235-5508
Practice Address - Street 1:2201 S W S YOUNG DR
Practice Address - Street 2:SUITE 117 A-1
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5317
Practice Address - Country:US
Practice Address - Phone:254-526-8255
Practice Address - Fax:254-526-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty