Provider Demographics
NPI:1568954915
Name:QUINTERO, OMAR ALBERTO (CF-SLP)
Entity Type:Individual
Prefix:
First Name:OMAR
Middle Name:ALBERTO
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:CF-SLP
Other - Prefix:MR
Other - First Name:OMAR
Other - Middle Name:ALBERTO
Other - Last Name:QUINTERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1537 PINION DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-1209
Mailing Address - Country:US
Mailing Address - Phone:956-295-9012
Mailing Address - Fax:
Practice Address - Street 1:35 BUSINESS DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-4499
Practice Address - Country:US
Practice Address - Phone:956-541-6976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114523235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist