Provider Demographics
NPI:1629733712
Name:CORTEZ, LAUREN ELAINE (MS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELAINE
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 HIGHVIEW LN
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-2965
Mailing Address - Country:US
Mailing Address - Phone:817-602-9979
Mailing Address - Fax:
Practice Address - Street 1:500 DOWELL ST
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5086
Practice Address - Country:US
Practice Address - Phone:469-302-2418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-03
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114565235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist