Provider Demographics
NPI:1497181804
Name:JONNALAGADDA, RANJITA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RANJITA
Middle Name:
Last Name:JONNALAGADDA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:APARANJITA
Other - Middle Name:
Other - Last Name:JONNALAGADDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2600 GESSNER RD STE 190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3844
Mailing Address - Country:US
Mailing Address - Phone:713-996-7996
Mailing Address - Fax:
Practice Address - Street 1:2600 GESSNER RD STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3844
Practice Address - Country:US
Practice Address - Phone:713-996-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453810320Medicaid