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General NPI Number Information
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NPI Number | 1699069294
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Entity Type | Organization
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Legal Business Name | TEXAS THERAPY SPECIALISTS
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Dates
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Enumeration Date | 06/01/2011
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Last Update Date | 06/01/2011
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Provider Practice Location Address
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Address Line | 705 E 43RD ST
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City | AUSTIN
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State | TX
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Zip | 78751-3912
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Country | US
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Telephone | 512-577-7057
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Fax | 512-524-3571
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Provider Business Mailing Address
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Address Line | 705 E 43RD ST
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City | AUSTIN
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State | TX
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Zip | 78751-3912
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Country | US
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Telephone | 512-577-7057
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Fax | 512-524-3571
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Authorized Official
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Title or Position | OWNER
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Name | MARIA FORERO
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Credential | CCC-SLP
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Telephone | 512-577-7057
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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 | 19854
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License Number State | TX
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