Provider Demographics
NPI:1760992945
Name:HOUSTON CORPORATE SPEECH PATHOLOGY
Entity Type:Organization
Organization Name:HOUSTON CORPORATE SPEECH PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:VALINTEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PENNICK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:832-736-5253
Mailing Address - Street 1:5757 FLEWELLEN OAKS LN STE 604
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1800
Mailing Address - Country:US
Mailing Address - Phone:832-736-5253
Mailing Address - Fax:832-553-2519
Practice Address - Street 1:5757 FLEWELLEN OAKS LN STE 604
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1800
Practice Address - Country:US
Practice Address - Phone:832-736-5253
Practice Address - Fax:832-553-2519
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105960235Z00000X
TX110604235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty