MEDICARE: KRISTEN COMAS BARDELAS M.S. CCC-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
2	235Z00000X	Speech-Language Pathologist	SP6206	OK

General Provider Information

NPI Number	:	1093440117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN COMAS BARDELAS M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1527 RIVERSIDE DR
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74119-3815
Country	:	US
Telephone Number	:	786-294-3936
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 RIVERSIDE DR
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74119-3815
Country	:	US
Telephone Number	:	786-294-3936
Fax Number	:

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

Provider Enumeration Date	:	07/21/2022
Last Update Date	:	07/02/2024

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Directions to “ KRISTEN COMAS BARDELAS M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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