Provider Demographics
NPI:1801197355
Name:ASSISTIVE TECHNOLOGY SERVICES OF TEXAS
Entity Type:Organization
Organization Name:ASSISTIVE TECHNOLOGY SERVICES OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:BARKER
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:512-293-0307
Mailing Address - Street 1:3014 W WILLIAM CANNON DR
Mailing Address - Street 2:1521
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5135
Mailing Address - Country:US
Mailing Address - Phone:512-293-0307
Mailing Address - Fax:
Practice Address - Street 1:3014 W WILLIAM CANNON DR
Practice Address - Street 2:1521
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5135
Practice Address - Country:US
Practice Address - Phone:512-293-0307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104189235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty