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NPI Code Detail

MEDICARE: MR. LUCIAN AZTLAN JUAREZ SLPA

MEDICARE: MR. LUCIAN AZTLAN JUAREZ SLPA
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
12355S0801XSpeech-Language Assistant44526TX

General Provider Information

NPI Number : 1376486043
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LUCIAN AZTLAN JUAREZ SLPA
Provider Business Mailing Address
First Line : 10450 BRIAN MOONEY AVE
Second Line :
City : EL PASO
State : TX
Zip : 79935-2809
Country : US
Telephone Number : 915-698-6616
Fax Number : 915-598-6651
Provider Business Practice Location Address
First Line : 10450 BRIAN MOONEY AVE
Second Line :
City : EL PASO
State : TX
Zip : 79935-2809
Country : US
Telephone Number : 915-698-6616
Fax Number : 915-598-6651
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2026
Last Update Date : 04/10/2026

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