Provider Demographics
NPI:1518016013
Name:PALACIOS, ELIZA (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:ELIZA
Middle Name:
Last Name:PALACIOS
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 623
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1611
Mailing Address - Country:US
Mailing Address - Phone:956-783-8994
Mailing Address - Fax:
Practice Address - Street 1:1200 E SAVANNAH AVE STE 10
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1728
Practice Address - Country:US
Practice Address - Phone:956-668-9900
Practice Address - Fax:956-668-9902
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15415235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist