Provider Demographics
NPI:1497024970
Name:ALMATROUD, AMAL
Entity Type:Individual
Prefix:
First Name:AMAL
Middle Name:
Last Name:ALMATROUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 PARISH LN
Mailing Address - Street 2:#521
Mailing Address - City:ROANOKE
Mailing Address - State:TX
Mailing Address - Zip Code:76262-6674
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 PARISH LN
Practice Address - Street 2:#521
Practice Address - City:ROANOKE
Practice Address - State:TX
Practice Address - Zip Code:76262-6674
Practice Address - Country:US
Practice Address - Phone:940-442-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106025235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist