Healthcare Provider Details

I. General information

NPI: 1821351149
Provider Name (Legal Business Name): ELIZABETH RODRIGUEZ SROUJI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 06/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7787 PINEMONT DR SUITE B
HOUSTON TX
77040-6216
US

IV. Provider business mailing address

1946 WESTCREST DR
HOUSTON TX
77055-1432
US

V. Phone/Fax

Practice location:
  • Phone: 713-686-9194
  • Fax: 713-686-9413
Mailing address:
  • Phone: 713-376-5592
  • Fax: 713-686-9413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number33725
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: