Provider Demographics
NPI:1912028259
Name:O'KILEN, BRENDA SCHUERMANN (SLP)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:SCHUERMANN
Last Name:O'KILEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 BISSONNET ST STE 340
Mailing Address - Street 2:BELLAIRE
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3009
Mailing Address - Country:US
Mailing Address - Phone:713-838-9050
Mailing Address - Fax:713-838-0926
Practice Address - Street 1:4500 BISSONNET ST STE 340
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3009
Practice Address - Country:US
Practice Address - Phone:713-838-9050
Practice Address - Fax:713-838-0926
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18749235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005427202Medicaid