Provider Demographics
NPI:1245407238
Name:AVILA-GONZALEZ, LINDA (SLP)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:AVILA-GONZALEZ
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 1:500 SPANISH OAK
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:TX
Mailing Address - Zip Code:78069-4678
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1460 MARTINEZ LOSOYA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-9648
Practice Address - Country:US
Practice Address - Phone:210-882-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist