MEDICARE: PRISCILLA KATE ESTELLO CCC-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	122452	TX

General Provider Information

NPI Number	:	1922963958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRISCILLA KATE ESTELLO CCC-SLP

Provider Business Mailing Address
First Line	:	1114 CROSSBROOK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6109
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1114 CROSSBROOK
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-6109
Country	:	US
Telephone Number	:	210-316-4903
Fax Number	:

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

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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Directions to “ PRISCILLA KATE ESTELLO CCC-SLP” Practice Location

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