MEDICARE: BRONCO BABBLE THERAPY SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	2355S0801X	Speech-Language Assistant
3	225100000X	Physical Therapist
4	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1437029683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRONCO BABBLE THERAPY SERVICES PLLC

Provider Business Mailing Address
First Line	:	16571 OASIS GLADE DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16571 OASIS GLADE DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77407-1222
Country	:	US
Telephone Number	:	346-639-6523
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AYESHA OWOLABI
Credential	:	CCC-SLP
Telephone Number	:	346-639-6523

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	11/21/2025

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