Individual provider Active NPI

Maria Lourdes Camangian-Rodriguez, CCC-SLP

  • Speech-Language Pathologist
  • Amarillo, TX
National Provider Identifier
1033699053
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
105590 Issued in TX
Practice address
6600 Killgore Dr
Amarillo, TX 79106-3700
Phone
(806) 350-2259
Fax
(806) 350-2129
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 105590 TX Primary

Addresses

Primary practice location

6600 Killgore Dr
Amarillo, TX 79106-3700

Mailing address

6600 Killgore Dr
Amarillo, TX 79106-3700
Phone (806) 350-2259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200611002354 TX Practitioner - Qualified Speech Language Pathologist 6204258601 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105590TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Century Rehabilitation of Texas LLC Speech-Language Pathologist CurrentSince Mar 9, 2023 Accepting new patients

Locations

4703 Bluebonnet Blvd
Baton Rouge, LA 70809
Phone (225) 661-2222

400 W 14th Ave
Amarillo, TX 79101
Phone (806) 337-4000

1510 S Van Buren St
Amarillo, TX 79101
Phone (806) 337-4000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1033699053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 KILLGORE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791063700",
            "telephone_number": "806-350-2259",
            "fax_number": "806-350-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 KILLGORE DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791063700",
            "telephone_number": "806-350-2259",
            "fax_number": "806-350-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMANGIAN-RODRIGUEZ",
        "first_name": "MARIA",
        "middle_name": "LOURDES",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "105590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.