Provider Demographics
NPI:1457244964
Name:LOPEZ, ROXANNA MARIE (SLPA)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:MARIE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:ROXANNA
Other - Middle Name:MARIE
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5412 BRAND ST STE 3
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9464
Mailing Address - Country:US
Mailing Address - Phone:956-488-1818
Mailing Address - Fax:956-488-1819
Practice Address - Street 1:5412 BRAND ST STE 3
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-9464
Practice Address - Country:US
Practice Address - Phone:956-488-1818
Practice Address - Fax:956-488-1819
Is Sole Proprietor?:No
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341722355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant