Individual provider Active NPI

Teairra Lynnise Rodriguez

  • Speech-Language Pathologist
  • Humble, TX
National Provider Identifier
1902387434
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104791 Issued in TX
Practice address
14949 Mesa Dr
Humble, TX 77396-2952
Phone
(281) 902-4152
NPI assigned
Aug 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 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 104791 TX Primary

Addresses

Primary practice location

14949 Mesa Dr
Humble, TX 77396-2952

Mailing address

14949 Mesa Dr
Humble, TX 77396-2952

Other names 1

  • Teaira Lynnise Green 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
104791TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1902387434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14949 MESA DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14949 MESA DR",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773962952",
            "telephone_number": "281-902-4152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "TEAIRRA",
        "middle_name": "LYNNISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TEAIRA",
            "last_name": "GREEN",
            "middle_name": "LYNNISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Humble, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.