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NPI Code Detail

MEDICARE: ANGELA JULIAN CCC-SLP

MEDICARE: ANGELA JULIAN 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 Pathologist121699TX

General Provider Information

NPI Number : 1558170233
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA JULIAN CCC-SLP
Provider Business Mailing Address
First Line : 5617 GRISSOM RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78238-2220
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5617 GRISSOM RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78238-2220
Country : US
Telephone Number : 210-436-9764
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2025
Last Update Date : 01/06/2025

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Directions to “ ANGELA JULIAN CCC-SLP” Practice Location

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