Healthcare Provider Details

I. General information

NPI: 1558629642
Provider Name (Legal Business Name): FRANCISCO ORLANDO CIFUENTES RODRIGUEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 12/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 WESTPARK DR SUITE 100
HOUSTON TX
77063-5277
US

IV. Provider business mailing address

20801 HIGHLAND KNOLLS DR APT 130
KATY TX
77450-5157
US

V. Phone/Fax

Practice location:
  • Phone: 713-528-3030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number111414
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number35549
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: