MEDICARE: ANAIS ANGELICA VILLALUNA 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	104315	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184946329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANAIS ANGELICA VILLALUNA SLP

Provider Business Mailing Address
First Line	:	26400 KUYKENDAHL RD STE C180-405
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77375-2882
Country	:	US
Telephone Number	:	713-820-0441
Fax Number	:	936-286-6463

Provider Business Practice Location Address
First Line	:	26400 KUYKENDAHL RD STE C180-405
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77375-2882
Country	:	US
Telephone Number	:	713-635-9462
Fax Number	:	936-286-6463

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

Provider Enumeration Date	:	02/15/2010
Last Update Date	:	09/15/2022

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