Individual provider Active NPI

Tina Marie Rodriguez

  • Speech-Language Pathologist
  • San Antonio, TX
National Provider Identifier
1578088266
Registry record updated Mar 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
113528 Issued in TX
Practice address
10839 Quarry Park
San Antonio, TX 78233-4681
Phone
(210) 888-7399
NPI assigned
Aug 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2024

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 113528 TX Primary

Addresses

Primary practice location

10839 Quarry Park
San Antonio, TX 78233-4681

Mailing address

10839 Quarry Park
San Antonio, TX 78233-4681
Phone (210) 888-7399

Other identifiers 1

IdentifierTypeStateIssuer
113528OtherTXSLP

Other names 1

  • Tina Marie Rodriguez Former name

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

LicenseStateTypeSpecialty
113528TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids DC, LLC Past Accepting new patients
TLC Kid'S Therapy PastSince Mar 1, 2021 Accepting new patients

Organizations & group practices 2

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": "1501718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710288000000",
    "number": "1578088266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10839 QUARRY PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782334681",
            "telephone_number": "210-888-7399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10839 QUARRY PARK",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782334681",
            "telephone_number": "210-888-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "TINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-03",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SLP",
            "identifier": "113528",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "RODRIGUEZ",
            "middle_name": "MARIE",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.