Provider Demographics
NPI:1568489995
Name:SPEECH THERAPY ASSOCIATES PLLC
Entity Type:Organization
Organization Name:SPEECH THERAPY ASSOCIATES PLLC
Other - Org Name:CONSOLIDATED REHABILITATION THERAPIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:512-396-0872
Mailing Address - Street 1:101 UHLAND ROAD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666
Mailing Address - Country:US
Mailing Address - Phone:512-396-0872
Mailing Address - Fax:512-396-1918
Practice Address - Street 1:101 UHLAND ROAD
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-396-0872
Practice Address - Fax:512-396-1918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676638Medicare Oscar/Certification