Provider Demographics
NPI:1184881260
Name:SMART-FADAIRO, RACHEL (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:SMART-FADAIRO
Suffix:
Gender:F
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 1:4011 CLAYTON GREENS CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-4084
Mailing Address - Country:US
Mailing Address - Phone:713-997-9460
Mailing Address - Fax:
Practice Address - Street 1:9100 SOUTHWEST FWY STE 161
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1584
Practice Address - Country:US
Practice Address - Phone:713-997-9460
Practice Address - Fax:281-558-2782
Is Sole Proprietor?:No
Enumeration Date:2008-05-17
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157322201Medicaid
TX88065TOtherBLUE CROSS BLUE SHIELD OF TEXAS