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General NPI Number Information
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NPI Number | 1689353443
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Entity Type | Individual
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Provider Name | MIRIAM PADILLA
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Gender | Female
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Dates
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Enumeration Date | 07/17/2023
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 703 ETHEL ST
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City | LUFKIN
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State | TX
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Zip | 75901-5148
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Country | US
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Telephone | 936-238-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 GREENWAY DR STE 500
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City | IRVING
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State | TX
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Zip | 75038-2444
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 43182
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License Number State | TX
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