MEDICARE: SMRM PLLC

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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1861107799
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMRM PLLC

Provider Business Mailing Address
First Line	:	12712 W LAKE HOUSTON PKWY STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-6469
Country	:	US
Telephone Number	:	832-699-7800
Fax Number	:

Provider Business Practice Location Address
First Line	:	13010 CALDBECK CREEK LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77044-1746
Country	:	US
Telephone Number	:	832-699-7800
Fax Number	:

Authorized Official
Title or Position	:	LICENSED PROFESSIONAL COUNSELOR
Name	:	DR. STEPHANIE MARIE RODRIGUEZ-MORALES
Credential	:	PSY.D
Telephone Number	:	832-699-7800

Provider Enumeration Date	:	01/16/2023
Last Update Date	:	05/27/2024

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Directions to “SMRM PLLC ” Practice Location

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