Healthcare Provider Details

I. General information

NPI: 1568710085
Provider Name (Legal Business Name): PATRICIA JEAN SITZES SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 N BEDELL AVE STE. B
DEL RIO TX
78840-8020
US

IV. Provider business mailing address

2201 N BEDELL AVE STE. B
DEL RIO TX
78840-8020
US

V. Phone/Fax

Practice location:
  • Phone: 830-774-1556
  • Fax: 830-774-6150
Mailing address:
  • Phone: 830-774-1556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18277
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: