Provider Demographics
NPI:1194042572
Name:RODRIGUEZ, ROLANDO (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ROLANDO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 ROYOLA ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-4787
Mailing Address - Country:US
Mailing Address - Phone:956-240-1551
Mailing Address - Fax:956-424-3734
Practice Address - Street 1:2101 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3228
Practice Address - Country:US
Practice Address - Phone:956-424-3733
Practice Address - Fax:956-424-3734
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist