Healthcare Provider Details

I. General information

NPI: 1104183003
Provider Name (Legal Business Name): BEST- BEYOND EXPECTATIONS SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 04/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 E EXPRESSWAY 83
LA JOYA TX
78560-4178
US

IV. Provider business mailing address

PO BOX 208
LA JOYA TX
78560-0208
US

V. Phone/Fax

Practice location:
  • Phone: 956-583-5000
  • Fax:
Mailing address:
  • Phone: 956-583-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number800875226
License Number StateTX

VIII. Authorized Official

Name: ANN MARIE REZA
Title or Position: OWNRR
Credential: SLP
Phone: 956-583-5000