Provider Demographics
NPI:1629685490
Name:OBARE, DAFFNEY VEALS
Entity Type:Individual
Prefix:
First Name:DAFFNEY
Middle Name:VEALS
Last Name:OBARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7106 CHESTNUT OAK LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3063
Mailing Address - Country:US
Mailing Address - Phone:956-280-3429
Mailing Address - Fax:
Practice Address - Street 1:2630 VALLEY FIELD DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1550
Practice Address - Country:US
Practice Address - Phone:713-429-4961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist