Provider Demographics
NPI:1568660892
Name:SPEECH SUCCESS, LLC
Entity Type:Organization
Organization Name:SPEECH SUCCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAVIOLA
Authorized Official - Middle Name:H
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:956-664-9395
Mailing Address - Street 1:1701 DOVE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3955
Mailing Address - Country:US
Mailing Address - Phone:956-664-9395
Mailing Address - Fax:956-661-9495
Practice Address - Street 1:1701 DOVE AVE STE D
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3955
Practice Address - Country:US
Practice Address - Phone:956-664-9395
Practice Address - Fax:956-661-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-09
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
TX19324235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty