MEDICARE: DEANNA RODRIGUEZ MENA MA. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	100316	TX

General Provider Information

NPI Number	:	1346242336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA RODRIGUEZ MENA MA. CCC-SLP

Provider Business Mailing Address
First Line	:	9343 NORTH LOOP E
Second Line	:	SUITE 226
City	:	HOUSTON
State	:	TX
Zip	:	77029-1251
Country	:	US
Telephone Number	:	713-674-5003
Fax Number	:	713-674-5009

Provider Business Practice Location Address
First Line	:	9343 NORTH LOOP E
Second Line	:	SUITE 226
City	:	HOUSTON
State	:	TX
Zip	:	77029-1251
Country	:	US
Telephone Number	:	713-674-5003
Fax Number	:	713-674-5009

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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Directions to “ DEANNA RODRIGUEZ MENA MA. CCC-SLP” Practice Location

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