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General NPI Number Information
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NPI Number | 1235529439
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Entity Type | Organization
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Legal Business Name | COVERED BY GRACE LLC
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 123 W CAMERON AVE
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City | ROCKDALE
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State | TX
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Zip | 76567-2801
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Country | US
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Telephone | 512-446-2559
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Fax |
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Provider Business Mailing Address
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Address Line | 2016 COUNTY ROAD 412
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City | LEXINGTON
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State | TX
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Zip | 78947-4911
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Country | US
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Telephone | 979-716-8185
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELINDA RICHARDS CATCHING
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Credential | PH.D.
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Telephone | 512-446-9130
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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 | 100815
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License Number State | TX
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