Healthcare Provider Details

I. General information

NPI: 1073806295
Provider Name (Legal Business Name): SUZANNE SEIFERT BINGHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23507 HALLIE HODGE CT
RICHMOND TX
77469-2537
US

IV. Provider business mailing address

23507 HALLIE HODGE CT
RICHMOND TX
77469-2537
US

V. Phone/Fax

Practice location:
  • Phone: 281-232-1900
  • Fax:
Mailing address:
  • Phone: 713-906-5555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number112659
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: