Provider Demographics
NPI:1235236282
Name:ALEXANDER, CATHY LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:LYNN
Last Name:ALEXANDER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4811 SUMMER LKS
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-3960
Mailing Address - Country:US
Mailing Address - Phone:281-261-6878
Mailing Address - Fax:
Practice Address - Street 1:4545 BISSONNET ST
Practice Address - Street 2:SUITE 215
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3121
Practice Address - Country:US
Practice Address - Phone:281-261-6878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102487235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7088315OtherAETNA PROVIDER NUMBER