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NPI Code Detail

MEDICARE: SPEECHOLOGY LIMITED LIABILITY COMPANY

MEDICARE: SPEECHOLOGY LIMITED LIABILITY COMPANY
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1457021644
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPEECHOLOGY LIMITED LIABILITY COMPANY
Provider Business Mailing Address
First Line : PO BOX 962416
Second Line :
City : EL PASO
State : TX
Zip : 79996-2416
Country : US
Telephone Number : 940-290-0389
Fax Number :
Provider Business Practice Location Address
First Line : 1214 DOLTON DR STE 202
Second Line :
City : DALLAS
State : TX
Zip : 75207-2108
Country : US
Telephone Number : 940-290-0389
Fax Number :
Authorized Official
Title or Position : SPEECH LANGUAGE PATHOLOGIST/OWNER
Name : ELIZABETH GOMEZ
Credential : MS.-CCC-SLP
Telephone Number : 915-929-5972
Provider Enumeration Date : 09/17/2021
Last Update Date : 09/17/2021

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Directions to “SPEECHOLOGY LIMITED LIABILITY COMPANY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.