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NPI Code Detail

MEDICARE: KRYSTAL ALLEN M.A., CCC-SLP

MEDICARE: KRYSTAL ALLEN M.A., 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
1235Z00000XSpeech-Language Pathologist105159TX

General Provider Information

NPI Number : 1265706121
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRYSTAL ALLEN M.A., CCC-SLP
Provider Business Mailing Address
First Line : 2900 WOODRIDGE DR STE 300
Second Line :
City : HOUSTON
State : TX
Zip : 77087-2506
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2900 WOODRIDGE DR STE 300
Second Line :
City : HOUSTON
State : TX
Zip : 77087-2506
Country : US
Telephone Number : 713-741-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2012
Last Update Date : 10/27/2012

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Directions to “ KRYSTAL ALLEN M.A., CCC-SLP” Practice Location

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