Provider Demographics
NPI:1417457029
Name:WEST, AVA (SLPA)
Entity Type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 HAYES RD APT 2425
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-6671
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2828 HAYES RD APT 2425
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-6671
Practice Address - Country:US
Practice Address - Phone:225-287-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech