MEDICARE: MISS ANN PATEK HELLER MS 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	106639	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	106639	OTHER	TX	STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY

General Provider Information

NPI Number	:	1730439506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS ANN PATEK HELLER MS CCC-SLP

Provider Business Mailing Address
First Line	:	7147 LOWER MISSION VALLEY RD
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77905-2723
Country	:	US
Telephone Number	:	361-772-4832
Fax Number	:

Provider Business Practice Location Address
First Line	:	12063 FM 236
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77905-2606
Country	:	US
Telephone Number	:	361-788-9514
Fax Number	:

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

Provider Enumeration Date	:	09/19/2012
Last Update Date	:	09/22/2022

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Directions to “ MISS ANN PATEK HELLER MS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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