Provider Demographics
NPI:1609912880
Name:RODRIGUEZ, PERLA V (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PERLA
Middle Name:V
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11923 ASHCROFT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4201
Mailing Address - Country:US
Mailing Address - Phone:832-283-7831
Mailing Address - Fax:
Practice Address - Street 1:4545 BISSONNET ST STE 215
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3114
Practice Address - Country:US
Practice Address - Phone:713-770-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102006235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist