Provider Demographics
| NPI: | 1346973674 |
|---|---|
| Name: | SLP NEURO CARE, PLLC |
| Entity Type: | Organization |
| Organization Name: | SLP NEURO CARE, PLLC |
| Other - Org Name: | SLP NEURO CARE |
| Other - Org Type: | Other Name |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | NANCY |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | WARIARI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MHA, MS CCC-SLP |
| Authorized Official - Phone: | 612-743-1519 |
| Mailing Address - Street 1: | 950 E STATE HIGHWAY 114 STE 160 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SOUTHLAKE |
| Mailing Address - State: | TX |
| Mailing Address - Zip Code: | 76092-5261 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 817-888-8721 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 950 E STATE HIGHWAY 114 STE 160 |
| Practice Address - Street 2: | |
| Practice Address - City: | SOUTHLAKE |
| Practice Address - State: | TX |
| Practice Address - Zip Code: | 76092-5261 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 817-888-8721 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-07-05 |
| Last Update Date: | 2023-09-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
| No | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
| No | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | Group - Multi-Specialty | |
| No | 225C00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Counselor | Group - Multi-Specialty | |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Group - Multi-Specialty | |
| No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | Group - Multi-Specialty |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | Group - Multi-Specialty |
