Provider Demographics
NPI:1053833848
Name:TAPIA, JANE ELSA (SLPA)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:ELSA
Last Name:TAPIA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:MS
Other - First Name:ELSA
Other - Middle Name:
Other - Last Name:RUIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:305 NE LOOP 820, BUSINESS TOWER 1, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053
Mailing Address - Country:US
Mailing Address - Phone:817-292-8787
Mailing Address - Fax:817-789-6849
Practice Address - Street 1:620 WHISPER HOLW
Practice Address - Street 2:
Practice Address - City:CARRIZO SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78834-4205
Practice Address - Country:US
Practice Address - Phone:210-303-7072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340822355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0123CARRIZOMedicaid