MEDICARE: ESSENTIAL SPEECH & SWALLOW THERAPY PLLC

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	:	1780253641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL SPEECH & SWALLOW THERAPY PLLC

Provider Business Mailing Address
First Line	:	957 NASA PKWY UNIT 2104
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3039
Country	:	US
Telephone Number	:	281-247-4656
Fax Number	:	561-948-2803

Provider Business Practice Location Address
First Line	:	4300 BAY AREA BLVD APT 3711
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-1145
Country	:	US
Telephone Number	:	281-247-4656
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MUMTAZ SHAH
Credential	:	MS-CCC-SLP
Telephone Number	:	281-247-4656

Provider Enumeration Date	:	06/23/2021
Last Update Date	:	12/06/2023

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Directions to “ESSENTIAL SPEECH & SWALLOW THERAPY PLLC ” Practice Location

Language	Start Address	Practice Location

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