Provider Demographics
NPI:1053714485
Name:CHAPA, ROXANNA (AUD)
Entity type:Individual
Prefix:
First Name:ROXANNA
Middle Name:
Last Name:CHAPA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N HEATHERWILDE BLVD
Mailing Address - Street 2:SUITE # 130
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-3757
Mailing Address - Country:US
Mailing Address - Phone:512-969-5087
Mailing Address - Fax:512-969-5096
Practice Address - Street 1:305 N HEATHERWILDE BLVD
Practice Address - Street 2:STE 130
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-4190
Practice Address - Country:US
Practice Address - Phone:512-969-5087
Practice Address - Fax:512-969-5096
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80604231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist