Provider Demographics
NPI:1417686866
Name:SEBESTA, JULIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SEBESTA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18513 LAKELAND DR
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-8724
Mailing Address - Country:US
Mailing Address - Phone:713-806-9513
Mailing Address - Fax:
Practice Address - Street 1:3311 RICHMOND AVE STE 230
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3024
Practice Address - Country:US
Practice Address - Phone:281-829-0103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist