Provider Demographics
NPI:1851474928
Name:NERIA, ALFONSO W (SLP)
Entity Type:Individual
Prefix:MR
First Name:ALFONSO
Middle Name:W
Last Name:NERIA
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 BOEING DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-1010
Mailing Address - Country:US
Mailing Address - Phone:915-780-6576
Mailing Address - Fax:915-780-5303
Practice Address - Street 1:6611 BOEING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1010
Practice Address - Country:US
Practice Address - Phone:915-780-6576
Practice Address - Fax:915-780-5303
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12885235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist