Provider Demographics
NPI:1508141326
Name:ALFARO, JESUS ALBERTO (BS ASSIST SLP)
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:ALBERTO
Last Name:ALFARO
Suffix:
Gender:M
Credentials:BS ASSIST SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 JOANNA AVE
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2734
Mailing Address - Country:US
Mailing Address - Phone:956-458-1752
Mailing Address - Fax:
Practice Address - Street 1:220 S BICENTENNIAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-7019
Practice Address - Country:US
Practice Address - Phone:956-688-6141
Practice Address - Fax:956-688-6997
Is Sole Proprietor?:No
Enumeration Date:2011-10-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX331902355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant