Healthcare Provider Details

I. General information

NPI: 1295175149
Provider Name (Legal Business Name): KAYLIN JOY OGBOR SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLIN THOMAS

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12605 EAST FWY SUITE 212
HOUSTON TX
77015-5625
US

IV. Provider business mailing address

11511 SHADOW CREEK PKWY
PEARLAND TX
77584-7298
US

V. Phone/Fax

Practice location:
  • Phone: 713-453-0400
  • Fax:
Mailing address:
  • Phone: 713-442-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number108932
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: