MEDICARE: YADIRA MEDINA-TORRES 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	104233	TX
2	235Z00000X	Speech-Language Pathologist	SAH-2026-0178	NM
3	235Z00000X	Speech-Language Pathologist	1036251	MN
4	235Z00000X	Speech-Language Pathologist	247937	AK

General Provider Information

NPI Number	:	1770727885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YADIRA MEDINA-TORRES SLP

Provider Business Mailing Address
First Line	:	1424 SCENIC VIEW DR
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-2200
Country	:	US
Telephone Number	:	210-885-2118
Fax Number	:	210-830-0620

Provider Business Practice Location Address
First Line	:	1424 SCENIC VIEW DR
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-2200
Country	:	US
Telephone Number	:	210-885-2118
Fax Number	:	210-830-0620

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

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	06/12/2026

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Directions to “ YADIRA MEDINA-TORRES SLP” Practice Location

Language	Start Address	Practice Location

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