Provider Demographics
NPI:1891233920
Name:RESENDIZ, CARLA (HIS)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:RESENDIZ
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N COMMONS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-7940
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:630-303-5385
Practice Address - Street 1:2700 N'OCONNONR
Practice Address - Street 2:STE. 102B
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4148
Practice Address - Country:US
Practice Address - Phone:972-252-9360
Practice Address - Fax:972-252-7516
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80725237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist