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General NPI Number Information
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NPI Number | 1780253641
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Entity Type | Organization
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Legal Business Name | ESSENTIAL SPEECH & SWALLOW THERAPY PLLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 12/06/2023
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Provider Practice Location Address
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Address Line | 4300 BAY AREA BLVD APT 3711
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City | HOUSTON
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State | TX
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Zip | 77058-1145
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Country | US
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Telephone | 281-247-4656
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Fax |
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Provider Business Mailing Address
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Address Line | 957 NASA PKWY UNIT 2104
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City | HOUSTON
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State | TX
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Zip | 77058-3039
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Country | US
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Telephone | 281-247-4656
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Fax | 561-948-2803
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Authorized Official
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Title or Position | OWNER
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Name | MS. MUMTAZ SHAH
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Credential | MS-CCC-SLP
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Telephone | 281-247-4656
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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 |
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License Number State |
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