MEDICARE: TANYA F LOFFLER 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	13940	TX

General Provider Information

NPI Number	:	1649562281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA F LOFFLER SLP

Provider Business Mailing Address
First Line	:	2621 RIDGEPOINT DR
Second Line	:	130
City	:	AUSTIN
State	:	TX
Zip	:	78754-5232
Country	:	US
Telephone Number	:	512-583-9679
Fax Number	:	512-334-2321

Provider Business Practice Location Address
First Line	:	2621 RIDGEPOINT DR
Second Line	:	140
City	:	AUSTIN
State	:	TX
Zip	:	78754-5232
Country	:	US
Telephone Number	:	512-744-6000
Fax Number	:	512-334-2325

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

Provider Enumeration Date	:	05/13/2011
Last Update Date	:	05/13/2011

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Directions to “ TANYA F LOFFLER SLP” Practice Location

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