1780082669 NPI number — ART OF SPEECH THERAPY CENTER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780082669 NPI number — ART OF SPEECH THERAPY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ART OF SPEECH THERAPY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780082669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3845 CYPRESS CREEK PKWY
Provider Second Line Business Mailing Address:
SUITE 283
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77068-3531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
832-446-6085
Provider Business Mailing Address Fax Number:
832-446-3699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3845 CYPRESS CREEK PKWY
Provider Second Line Business Practice Location Address:
SUITE 283
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77068-3531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
832-446-6085
Provider Business Practice Location Address Fax Number:
832-446-3699
Provider Enumeration Date:
12/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
BALL
Authorized Official First Name:
COURTNEY
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
832-446-6085

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  103594 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 208435201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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