Provider Demographics
NPI:1093215725
Name:ESTATUET, BEGONA
Entity Type:Individual
Prefix:
First Name:BEGONA
Middle Name:
Last Name:ESTATUET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 GREENLAWN DR
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-8224
Mailing Address - Country:US
Mailing Address - Phone:214-934-3060
Mailing Address - Fax:
Practice Address - Street 1:2605 GREENLAWN DR
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-8224
Practice Address - Country:US
Practice Address - Phone:214-934-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2018-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX366682355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant