MEDICARE: MRS. MONICA CONTRERAS-TULLIUS 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	16577	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760649537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MONICA CONTRERAS-TULLIUS M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1512 N ZARAGOZA RD STE C1
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8903
Country	:	US
Telephone Number	:	915-855-0601
Fax Number	:	915-855-0751

Provider Business Practice Location Address
First Line	:	1512 N ZARAGOZA RD STE C1
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-8903
Country	:	US
Telephone Number	:	915-855-0601
Fax Number	:	915-855-0751

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

Provider Enumeration Date	:	05/20/2008
Last Update Date	:	11/02/2020

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