Provider Demographics
NPI:1164036174
Name:ALSUP, EMILY (SLP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:ALSUP
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 1:1010 SOUTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3719
Mailing Address - Country:US
Mailing Address - Phone:214-934-4343
Mailing Address - Fax:
Practice Address - Street 1:7801 WOODWAY DR
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-3860
Practice Address - Country:US
Practice Address - Phone:254-235-7801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117330235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist