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NPI Code Detail

MEDICARE: PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC

MEDICARE: PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC
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 Pathologist105978TX

General Provider Information

NPI Number : 1912298613
Entity Type Code : Organization
Provider Name (Legal Business Name) : PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC
Provider Business Mailing Address
First Line : 4925 GREENVILLE AVE
Second Line : SUITE 200
City : DALLAS
State : TX
Zip : 75206-4026
Country : US
Telephone Number : 214-988-5437
Fax Number : 972-552-2152
Provider Business Practice Location Address
First Line : 4925 GREENVILLE AVE
Second Line : SUITE 200
City : DALLAS
State : TX
Zip : 75206-4026
Country : US
Telephone Number : 214-988-5437
Fax Number : 972-552-2152
Authorized Official
Title or Position : CEO/SPEECH-LANGUAGE PATHOLOGIST
Name : MRS. NATALIE JONES EVANS
Credential : M.S.,CCC-SLP
Telephone Number : 214-625-2218
Provider Enumeration Date : 04/28/2011
Last Update Date : 04/28/2011

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Directions to “PUZZLE PIECE KIDS PEDIATRIC THERAPIES, LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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