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General NPI Number Information
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NPI Number | 1679855803
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Entity Type | Organization
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Legal Business Name | MARYBEL L PANTOJA SPEECH THERAPY SERVICES PLLC
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 1309 E. NOLANA AVE. STE. C
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City | MCALLEN
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State | TX
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Zip | 78504-6190
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Country | US
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Telephone | 956-631-7674
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Fax | 956-631-0075
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Provider Business Mailing Address
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Address Line | 1309 E. NOLANA AVE. STE. C
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City | MCALLEN
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State | TX
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Zip | 78504-6190
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Country | US
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Telephone | 956-631-7674
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Fax | 956-631-0075
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARYBEL L. PANTOJA
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Credential | SLP
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Telephone | 956-631-7674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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