Provider Demographics
NPI:1538648704
Name:COVARRUBIAS, AIDEE (BS SLP-ASSISTANT)
Entity Type:Individual
Prefix:
First Name:AIDEE
Middle Name:
Last Name:COVARRUBIAS
Suffix:
Gender:F
Credentials:BS SLP-ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-3663
Mailing Address - Country:US
Mailing Address - Phone:956-221-0085
Mailing Address - Fax:
Practice Address - Street 1:300 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2702
Practice Address - Country:US
Practice Address - Phone:956-683-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35533235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty