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General NPI Number Information
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NPI Number | 1710309521
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Entity Type | Individual
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Provider Name | ISRAEL MALDONADO B.S. ASSISTANT SLP
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Gender | Male
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Dates
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Enumeration Date | 01/14/2014
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Last Update Date | 01/14/2014
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Provider Practice Location Address
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Address Line | 201 PENA AVE
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City | WESLACO
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State | TX
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Zip | 78599-4113
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Country | US
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Telephone | 956-498-5219
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Fax | 956-968-3233
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Provider Business Mailing Address
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Address Line | 201 PENA AVE
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City | WESLACO
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State | TX
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Zip | 78599-4113
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Country | US
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Telephone | 956-498-5219
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Fax | 956-968-3233
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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 | 34296
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License Number State | TX
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