Provider Demographics
NPI:1952654030
Name:KAREN L DULYUNAN
Entity Type:Organization
Organization Name:KAREN L DULYUNAN
Other - Org Name:SUGAR LAND SPEECH AND LANGUAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SPEECH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DULYUNAN
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP
Authorized Official - Phone:281-201-5419
Mailing Address - Street 1:138 ELDRIDGE RD STE B
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4083
Mailing Address - Country:US
Mailing Address - Phone:281-201-5419
Mailing Address - Fax:281-605-5277
Practice Address - Street 1:138 ELDRIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4083
Practice Address - Country:US
Practice Address - Phone:281-201-5419
Practice Address - Fax:281-605-5277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-26
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101217235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175985402Medicaid