Healthcare Provider Details

I. General information

NPI: 1982525945
Provider Name (Legal Business Name): ANJALI ROSE AUGUSTINE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 NW 23RD ST STE 2D
OKLAHOMA CITY OK
73107-2420
US

IV. Provider business mailing address

6915 S GOLD RIVER CIR
MISSOURI CITY TX
77459-5068
US

V. Phone/Fax

Practice location:
  • Phone: 405-355-3239
  • Fax:
Mailing address:
  • Phone: 832-689-6167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCF956
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: