MEDICARE: LINDA R. PRAVDA

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	10315	TX

General Provider Information

NPI Number	:	1841527868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA R. PRAVDA

Provider Business Mailing Address
First Line	:	5707 CLARIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-6005
Country	:	US
Telephone Number	:	713-721-1488
Fax Number	:	713-721-1488

Provider Business Practice Location Address
First Line	:	5707 CLARIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-6005
Country	:	US
Telephone Number	:	713-721-1488
Fax Number	:	713-721-1488

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

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	11/12/2009

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