Provider Demographics
NPI:1013055029
Name:RODRIGUEZ, SORAYA C (PT)
Entity Type:Individual
Prefix:MS
First Name:SORAYA
Middle Name:C
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3876
Mailing Address - Country:US
Mailing Address - Phone:281-565-8800
Mailing Address - Fax:281-565-8808
Practice Address - Street 1:15400 SOUTHWEST FWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3876
Practice Address - Country:US
Practice Address - Phone:281-565-8800
Practice Address - Fax:281-565-8808
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1055945225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G5301Medicare ID - Type Unspecified