MEDICARE: MRS. ANGELA EDDA SOTOLONGO-GREWAL 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
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1588078257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA EDDA SOTOLONGO-GREWAL M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	4807 SPICEWOOD SPRINGS RD STE 1120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8435
Country	:	US
Telephone Number	:	737-326-0393
Fax Number	:	512-617-7443

Provider Business Practice Location Address
First Line	:	4807 SPICEWOOD SPRINGS RD STE 1120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78759-8435
Country	:	US
Telephone Number	:	737-326-0393
Fax Number	:	512-617-7443

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

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	07/14/2025

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