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General NPI Number Information
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NPI Number | 1124271325
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Entity Type | Organization
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Legal Business Name | APPLES AND BANANAS INC.
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | C4501 CARTWRIGHT RD #301
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City | MISSOURI CITY
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State | TX
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Zip | 77459-3534
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Country | US
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Telephone | 281-403-1900
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Fax | 281-403-1910
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Provider Business Mailing Address
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Address Line | 4501 CARTWRIGHT RD #301
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City | MISSOURI CITY
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State | TX
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Zip | 77459-3534
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Country | US
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Telephone | 281-403-1900
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Fax | 281-403-1910
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Authorized Official
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Title or Position | SLP
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Name | MRS. SHANNON LEWIS SERVANCE
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Credential | MA CCC-SLP
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Telephone | 281-403-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 16446
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License Number State | TX
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