MEDICARE: ERIC ALBERT NAVARRO SLP

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
1	235Z00000X	Speech-Language Pathologist	104988	TX

General Provider Information

NPI Number	:	1659632438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC ALBERT NAVARRO SLP

Provider Business Mailing Address
First Line	:	4609 SAN DARIO AVE STE 9
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-5773
Country	:	US
Telephone Number	:	956-723-6600
Fax Number	:	956-723-6614

Provider Business Practice Location Address
First Line	:	4609 SAN DARIO AVE STE 9
Second Line	:
City	:	LAREDO
State	:	TX
Zip	:	78041-5773
Country	:	US
Telephone Number	:	956-723-6600
Fax Number	:	956-723-6614

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2012
Last Update Date	:	06/07/2012

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Directions to “ ERIC ALBERT NAVARRO SLP” Practice Location

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