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NPI Code Detail

MEDICARE: ELIZABETH HERNANDEZ SLP, CCC

MEDICARE: ELIZABETH HERNANDEZ SLP, CCC
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
1235Z00000XSpeech-Language Pathologist101559TX

General Provider Information

NPI Number : 1841540093
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH HERNANDEZ SLP, CCC
Provider Business Mailing Address
First Line : 17045 EL CAMINO REAL STE 106
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2623
Country : US
Telephone Number : 281-480-5648
Fax Number :
Provider Business Practice Location Address
First Line : 17045 EL CAMINO REAL STE 106
Second Line :
City : HOUSTON
State : TX
Zip : 77058-2623
Country : US
Telephone Number : 281-480-5648
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2012
Last Update Date : 06/13/2013

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Directions to “ ELIZABETH HERNANDEZ SLP, CCC” Practice Location

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