=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427286053
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TOVAR SMITH HOLMES MA, CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2009
-----------------------------------------------------
Last Update Date | 06/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17515 SPRING CYPRESS RD SUITE # C124
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-2688
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-701-3972
-----------------------------------------------------
Fax | 281-256-2385
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14314 ROSEHILL ESTATES LN
-----------------------------------------------------
City | CYPRESS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77429-8075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-701-3972
-----------------------------------------------------
Fax | 281-256-2385
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 18821
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------