Provider Demographics
NPI:1609874411
Name:BASTIDAS, DEBORAH ANN (MS, CCC, SLP)
Entity Type:Individual
Prefix:MISS
First Name:DEBORAH
Middle Name:ANN
Last Name:BASTIDAS
Suffix:
Gender:F
Credentials:MS, CCC, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5909 WEST LOOP S
Mailing Address - Street 2:#270
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-2402
Mailing Address - Country:US
Mailing Address - Phone:713-668-8800
Mailing Address - Fax:713-668-0098
Practice Address - Street 1:5909 WEST LOOP S
Practice Address - Street 2:#270
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2402
Practice Address - Country:US
Practice Address - Phone:713-668-8800
Practice Address - Fax:713-668-0098
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13254235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist