Basic Information
| Provider Information | |||||||||
| NPI: | 1013055029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RODRIGUEZ | ||||||||
| FirstName: | SORAYA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15400 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774783876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815658800 | ||||||||
| FaxNumber: | 2815658808 | ||||||||
| Practice Location | |||||||||
| Address1: | 15400 SOUTHWEST FWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774783876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815658800 | ||||||||
| FaxNumber: | 2815658808 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 1055945 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.