Active NPI
Audrey Corrin Rodriquez
- Speech-Language Pathologist
- Plainview, TX
National Provider Identifier
1104590454
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 116813
- Practice address
- 2417 Yonkers St
Plainview, TX 79072-1819 - Phone
- (806) 293-6090
- NPI assigned
- Aug 2, 2021
- Last updated
- Aug 12, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 116813 | TX | Primary |
Addresses
Primary practice location
2417 Yonkers St
Plainview, TX 79072-1819
Mailing address
1103 Holly St
Levelland, TX 79336-5763
Phone (806) 535-1716
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116813 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1104590454",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1103 HOLLY ST",
"city": "LEVELLAND",
"state": "TX",
"postal_code": "793365763",
"telephone_number": "806-535-1716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2417 YONKERS ST",
"city": "PLAINVIEW",
"state": "TX",
"postal_code": "790721819",
"telephone_number": "806-293-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIQUEZ",
"first_name": "AUDREY",
"middle_name": "CORRIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-02",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "116813",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plainview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.