Provider Demographics
NPI:1659632438
Name:NAVARRO, ERIC ALBERT (SLP)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:ALBERT
Last Name:NAVARRO
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 SAN DARIO AVE STE 9
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5773
Mailing Address - Country:US
Mailing Address - Phone:956-723-6600
Mailing Address - Fax:956-723-6614
Practice Address - Street 1:4609 SAN DARIO AVE STE 9
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5773
Practice Address - Country:US
Practice Address - Phone:956-723-6600
Practice Address - Fax:956-723-6614
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist