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NPI Code Detail

MEDICARE: DIANA E. PRADO M.S., CCC-SLP

MEDICARE: DIANA E. PRADO M.S., 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 Pathologist104755TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
132965OTHERTXLICENSE

General Provider Information

NPI Number : 1538215835
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA E. PRADO M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1301 WILDROSE LN
Second Line :
City : LAREDO
State : TX
Zip : 78041-3307
Country : US
Telephone Number : 956-220-7652
Fax Number :
Provider Business Practice Location Address
First Line : 6550 SPRINGFIELD AVE STE 101
Second Line :
City : LAREDO
State : TX
Zip : 78041-6712
Country : US
Telephone Number : 956-725-4555
Fax Number : 956-725-3555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2007
Last Update Date : 05/31/2011

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Directions to “ DIANA E. PRADO M.S., CCC-SLP” Practice Location

Language Start Address Practice Location
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