Provider Demographics
NPI:1093102469
Name:AVILA, LUZ MARGARITA (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:MARGARITA
Last Name:AVILA
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8613 CHULA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:MONTE ALTO
Mailing Address - State:TX
Mailing Address - Zip Code:78538-0179
Mailing Address - Country:US
Mailing Address - Phone:956-355-1153
Mailing Address - Fax:
Practice Address - Street 1:1900 S JACKSON RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503
Practice Address - Country:US
Practice Address - Phone:956-630-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist