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General NPI Number Information
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NPI Number | 1275389785
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Entity Type | Individual
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Provider Name | TASHAUNDA MONEQUE RODGERS
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Gender | Female
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 10206 ROSEHAVEN DR
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City | HOUSTON
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State | TX
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Zip | 77051-3612
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Country | US
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Telephone | 725-248-8315
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Fax |
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Provider Business Mailing Address
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Address Line | 4200 FM 1960 RD W APT 732
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City | HOUSTON
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State | TX
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Zip | 77068-3436
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Country | US
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Telephone | 725-248-8315
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number | 1343548350002
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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