MEDICARE: PRISCILLA DE LA ROSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant	43850	TX

General Provider Information

NPI Number	:	1073461000
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA DE LA ROSA

Provider Business Mailing Address
First Line	:	948 BALLENGER ST
Second Line	:
City	:	SAN BENITO
State	:	TX
Zip	:	78586-2722
Country	:	US
Telephone Number	:	956-734-7420
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 N ED CAREY DR
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8205
Country	:	US
Telephone Number	:	956-734-7420
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2026
Last Update Date	:	03/17/2026

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Directions to “ PRISCILLA DE LA ROSA ” Practice Location

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