MEDICARE: GEORGINA BARRERA S.L.P.

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	16950	TX

General Provider Information

NPI Number	:	1285899591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGINA BARRERA S.L.P.

Provider Business Mailing Address
First Line	:	2267 TRAWOOD DR STE G3
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-3027
Country	:	US
Telephone Number	:	915-307-9289
Fax Number	:	512-858-9582

Provider Business Practice Location Address
First Line	:	2267 TRAWOOD DR STE G3
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79935-3027
Country	:	US
Telephone Number	:	915-307-9289
Fax Number	:	915-975-8168

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

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	03/04/2020

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Directions to “ GEORGINA BARRERA S.L.P.” Practice Location

Language	Start Address	Practice Location

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