Provider Demographics
NPI:1033477559
Name:JUAREZ, OFELIA S (LHAS)
Entity Type:Individual
Prefix:MRS
First Name:OFELIA
Middle Name:S
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:LHAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:632 N ED CAREY DR
Mailing Address - Street 2:STE. # 100
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7508
Mailing Address - Country:US
Mailing Address - Phone:956-425-3298
Mailing Address - Fax:956-425-4321
Practice Address - Street 1:632 N ED CAREY DR
Practice Address - Street 2:STE 100
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7508
Practice Address - Country:US
Practice Address - Phone:956-425-3298
Practice Address - Fax:956-425-4321
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50094237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1127755-03Medicaid