Provider Demographics
NPI:1760235758
Name:OCONNOR, DENNIS KEITH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:KEITH
Last Name:OCONNOR
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DENNIS
Other - Middle Name:KEITH
Other - Last Name:OCONNOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:32100 DOBBIN HUFFSMITH RD # 77354
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-6389
Mailing Address - Country:US
Mailing Address - Phone:936-297-0417
Mailing Address - Fax:
Practice Address - Street 1:32100 DOBBIN HUFFSMITH RD # 77354
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-6389
Practice Address - Country:US
Practice Address - Phone:936-297-0417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100517235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist