MEDICARE: MISS JULIA MAZICK

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	105573	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	105573	OTHER	TX	TEXAS STATE BOARD OF EXAMINERS FOR SPEECH LANGUAGE PATHOLOGIST AND AUDIOLOGIST

General Provider Information

NPI Number	:	1144656968
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIA MAZICK

Provider Business Mailing Address
First Line	:	814 ARION PKWY STE 434
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-2837
Country	:	US
Telephone Number	:	210-355-0984
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 ARION PKWY STE 434
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-2837
Country	:	US
Telephone Number	:	210-355-0984
Fax Number	:

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

Provider Enumeration Date	:	09/25/2013
Last Update Date	:	03/03/2025

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Directions to “ MISS JULIA MAZICK ” Practice Location

Language	Start Address	Practice Location

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