Provider Demographics
NPI:1659745446
Name:BEYOND SPEECH THERAPY , PLLC
Entity Type:Organization
Organization Name:BEYOND SPEECH THERAPY , PLLC
Other - Org Name:N/A
Other - Org Type:Other Name
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:972-935-4752
Mailing Address - Street 1:1809 W LOOP 281
Mailing Address - Street 2:STE100 PMB153
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75604-2571
Mailing Address - Country:US
Mailing Address - Phone:903-309-3816
Mailing Address - Fax:844-862-6340
Practice Address - Street 1:1809 W LOOP 281
Practice Address - Street 2:STE100 PMB153
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2571
Practice Address - Country:US
Practice Address - Phone:903-309-3816
Practice Address - Fax:844-862-6340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty