Healthcare Provider Details

I. General information

NPI: 1134433196
Provider Name (Legal Business Name): CLAUDIA LIZETTE CUELLAR B.A., SLP-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2010
Last Update Date: 08/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S AIRPORT DR SUITE B
WESLACO TX
78596-5395
US

IV. Provider business mailing address

415 S AIRPORT DR SUITE B
WESLACO TX
78596-5395
US

V. Phone/Fax

Practice location:
  • Phone: 956-973-8400
  • Fax: 956-973-8403
Mailing address:
  • Phone: 956-973-8400
  • Fax: 956-973-8403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number34870
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: