Provider Demographics
NPI:1063847895
Name:HEUSTON, LAURA KAY (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:KAY
Last Name:HEUSTON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 FM 407 E
Mailing Address - Street 2:SUITE 145-146
Mailing Address - City:BARTONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-7012
Mailing Address - Country:US
Mailing Address - Phone:972-315-2974
Mailing Address - Fax:972-459-3418
Practice Address - Street 1:9610 ARROWGRASS DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-5272
Practice Address - Country:US
Practice Address - Phone:972-315-2974
Practice Address - Fax:972-459-3418
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16210235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist