Provider Demographics
NPI:1447428479
Name:VANEK, ANGELA BETH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:BETH
Last Name:VANEK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FM 1488 RD
Mailing Address - Street 2:STE. 120
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3817
Mailing Address - Country:US
Mailing Address - Phone:936-321-3837
Mailing Address - Fax:936-273-3838
Practice Address - Street 1:3600 FM 1488 RD
Practice Address - Street 2:STE. 120
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3817
Practice Address - Country:US
Practice Address - Phone:936-321-3837
Practice Address - Fax:936-273-3838
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist