Provider Demographics
NPI:1790779668
Name:MASTERSON, DENISE SLANICKY (AUD)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:SLANICKY
Last Name:MASTERSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:DENISE
Other - Middle Name:ANN
Other - Last Name:SLANICKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:STE 2001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-796-2001
Mailing Address - Fax:713-796-2349
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-796-2001
Practice Address - Fax:713-796-2349
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51086231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist