MEDICARE: MRS. DEVIN LE SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	101309	TX

General Provider Information

NPI Number	:	1033257191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEVIN LE SLP

Provider Business Mailing Address
First Line	:	10314 CAPE HATTERAS WAY
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2441
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10314 CAPE HATTERAS WAY
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-2441
Country	:	US
Telephone Number	:	713-668-6690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	07/08/2007

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