Provider Demographics
NPI:1740569250
Name:LJHC SPEECH PATHOLOGY SERVICES INC
Entity Type:Organization
Organization Name:LJHC SPEECH PATHOLOGY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEEJANE
Authorized Official - Middle Name:
Authorized Official - Last Name:HONG-COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC-SLP
Authorized Official - Phone:713-417-0280
Mailing Address - Street 1:14511 FALLING CREEK DR STE 102
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1279
Mailing Address - Country:US
Mailing Address - Phone:713-417-0280
Mailing Address - Fax:281-583-7336
Practice Address - Street 1:14511 FALLING CREEK DR STE 102
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1279
Practice Address - Country:US
Practice Address - Phone:713-417-0280
Practice Address - Fax:281-583-7336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10423235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175989601Medicaid