Provider Demographics
NPI:1235303777
Name:BUMGARDNER, CATHY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:BUMGARDNER
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 1:2811 PANAGARD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1858
Mailing Address - Country:US
Mailing Address - Phone:281-733-4451
Mailing Address - Fax:281-741-1301
Practice Address - Street 1:2811 PANAGARD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1858
Practice Address - Country:US
Practice Address - Phone:281-733-4451
Practice Address - Fax:281-741-1301
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist