Provider Demographics
NPI:1306354378
Name:ROGERS-ARCOS, ACACIA MARIE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ACACIA
Middle Name:MARIE
Last Name:ROGERS-ARCOS
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5600 CHENEVERT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7228
Mailing Address - Country:US
Mailing Address - Phone:832-297-8386
Mailing Address - Fax:
Practice Address - Street 1:5900 MEMORIAL DR STE 302
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007-8008
Practice Address - Country:US
Practice Address - Phone:832-794-9007
Practice Address - Fax:832-794-9007
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-12
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX107163OtherTEXAS DEPT OF LICENSING AND REGULATION