MEDICARE: MS. PATRICIA ANN RODRIGUEZ SLP-A

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	33258	TX

General Provider Information

NPI Number	:	1942487574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PATRICIA ANN RODRIGUEZ SLP-A

Provider Business Mailing Address
First Line	:	160 W EXPRESSWAY 83 STE F
Second Line	:
City	:	SAN BENITO
State	:	TX
Zip	:	78586-3836
Country	:	US
Telephone Number	:	956-361-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	160 W EXPRESSWAY 83 STE F
Second Line	:
City	:	SAN BENITO
State	:	TX
Zip	:	78586-3836
Country	:	US
Telephone Number	:	956-361-5800
Fax Number	:

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

Provider Enumeration Date	:	01/25/2008
Last Update Date	:	01/25/2008

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