Healthcare Provider Details

I. General information

NPI: 1093060428
Provider Name (Legal Business Name): KRISTI ANN MASTERS M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2012
Last Update Date: 07/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 SIDNEY BAKER ST S STE 102
KERRVILLE TX
78028-5915
US

IV. Provider business mailing address

1518 OLD RANCH ROAD 12 APT. 605
SAN MARCOS TX
78666-2957
US

V. Phone/Fax

Practice location:
  • Phone: 830-896-3130
  • Fax:
Mailing address:
  • Phone: 210-632-3238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15135
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: