Healthcare Provider Details

I. General information

NPI: 1992130322
Provider Name (Legal Business Name): EMMA LEA PURIFOY M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA LEA THOMAS

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15911 NACOGDOCHES RD BLDG 1
SAN ANTONIO TX
78247-1107
US

IV. Provider business mailing address

15911 NACOGDOCHES RD BLDG 1
SAN ANTONIO TX
78247-1107
US

V. Phone/Fax

Practice location:
  • Phone: 210-599-7733
  • Fax: 210-599-3105
Mailing address:
  • Phone: 210-599-7733
  • Fax: 210-599-3105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: