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General NPI Number Information
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NPI Number | 1477978757
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Entity Type | Organization
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Legal Business Name | BEAR FRUIT SPEECH THERAPY LLC
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 9889 CYPRESSWOOD DR APT 3306
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City | HOUSTON
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State | TX
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Zip | 77070-3972
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Country | US
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Telephone | 832-454-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 9889 CYPRESSWOOD DR APT 3306
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City | HOUSTON
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State | TX
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Zip | 77070-3972
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Country | US
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Telephone | 832-454-1911
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Fax |
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Authorized Official
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Title or Position | SPEECH PATHOLOGIST
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Name | MR. CAREEM J MCBEAN
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Credential | CCC/SLP
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Telephone | 832-454-1911
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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 | 0801918882
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License Number State | TX
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