Provider Demographics
NPI:1093483695
Name:PATLAN, DEYANIRA (MS, SLP-CFY)
Entity Type:Individual
Prefix:
First Name:DEYANIRA
Middle Name:
Last Name:PATLAN
Suffix:
Gender:F
Credentials:MS, SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:TX
Mailing Address - Zip Code:78594-0733
Mailing Address - Country:US
Mailing Address - Phone:956-564-1423
Mailing Address - Fax:
Practice Address - Street 1:5200A DEER LN,
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749
Practice Address - Country:US
Practice Address - Phone:512-301-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist