Provider Demographics
NPI:1568668291
Name:ESCALANTE, VIRGINIA (SLP)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:ESCALANTE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:VIRGINIA
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:224 W OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3623
Mailing Address - Country:US
Mailing Address - Phone:956-233-5400
Mailing Address - Fax:956-233-5406
Practice Address - Street 1:224 W OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:LOS FRESNOS
Practice Address - State:TX
Practice Address - Zip Code:78566-3623
Practice Address - Country:US
Practice Address - Phone:956-233-5400
Practice Address - Fax:956-233-5406
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102922235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102922OtherSTATE LICENSE