MEDICARE: MR. CESAR ENRIQUE RODARTE JR. 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	123930	TX

General Provider Information

NPI Number	:	1629953757
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CESAR ENRIQUE RODARTE JR. SLP

Provider Business Mailing Address
First Line	:	8155 LOMITA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3622
Country	:	US
Telephone Number	:	915-226-5855
Fax Number	:

Provider Business Practice Location Address
First Line	:	8155 LOMITA DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79907-3622
Country	:	US
Telephone Number	:	915-226-5855
Fax Number	:

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

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

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