Provider Demographics
NPI:1790975480
Name:BADILLO, JEANNE M
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:BADILLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3901
Mailing Address - Country:US
Mailing Address - Phone:713-666-1704
Mailing Address - Fax:713-666-1184
Practice Address - Street 1:921 FM 1960 RD W
Practice Address - Street 2:SUITE 101B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2505
Practice Address - Country:US
Practice Address - Phone:281-397-7232
Practice Address - Fax:281-397-8327
Is Sole Proprietor?:No
Enumeration Date:2007-07-28
Last Update Date:2007-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50488237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist