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General NPI Number Information
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NPI Number | 1770731192
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Entity Type | Organization
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Legal Business Name | CENTER FOR FUNCTIONAL COMMUNICATION PLLC
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 32443 WATERFORD CREST LN
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City | FULSHEAR
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State | TX
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Zip | 77441-3003
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Country | US
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Telephone | 832-563-3225
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Fax | 281-346-8090
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Provider Business Mailing Address
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Address Line | 32443 WATERFORD CREST LN
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City | FULSHEAR
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State | TX
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Zip | 77441-3003
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Country | US
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Telephone | 832-563-3225
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Fax | 281-346-8090
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH C RODRIGUEZ
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Credential | MA, CCC-SLP
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Telephone | 832-563-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 19877
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License Number State | TX
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