Healthcare Provider Details

I. General information

NPI: 1194517391
Provider Name (Legal Business Name): ISABELLA HURTADO SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 05/26/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 NACOGDOCHES RD STE 108
SAN ANTONIO TX
78217-4502
US

IV. Provider business mailing address

3030 NACOGDOCHES RD STE 108
SAN ANTONIO TX
78217-4502
US

V. Phone/Fax

Practice location:
  • Phone: 830-570-4492
  • Fax: 210-568-4937
Mailing address:
  • Phone: 830-570-4492
  • Fax: 210-568-4937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number122754
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: