Healthcare Provider Details

I. General information

NPI: 1841850385
Provider Name (Legal Business Name): SUNDARI MICHELLE ZAMORA M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 COLD SPG
BUDA TX
78610-3574
US

IV. Provider business mailing address

291 COLD SPG
BUDA TX
78610-3574
US

V. Phone/Fax

Practice location:
  • Phone: 575-707-3527
  • Fax:
Mailing address:
  • Phone: 575-707-3527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP7051
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-3461
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number124783
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: