Provider Demographics
NPI:1467725663
Name:RODRIGUEZ-MICIAK, ADRIANA (AUD)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:
Last Name:RODRIGUEZ-MICIAK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST STE 1701
Mailing Address - Street 2:ATT: RENEE BROWN
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2709
Mailing Address - Country:US
Mailing Address - Phone:713-798-8291
Mailing Address - Fax:713-798-5294
Practice Address - Street 1:6501 FANNIN ST
Practice Address - Street 2:NA 200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2703
Practice Address - Country:US
Practice Address - Phone:713-798-8309
Practice Address - Fax:713-793-1749
Is Sole Proprietor?:No
Enumeration Date:2012-02-17
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80398231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist