Provider Demographics
NPI:1962448233
Name:WATSON, PAULA RENEE (AUD,CCC-A)
Entity Type:Individual
Prefix:MS
First Name:PAULA
Middle Name:RENEE
Last Name:WATSON
Suffix:
Gender:F
Credentials:AUD,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W 20TH ST STE 203
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2400
Mailing Address - Country:US
Mailing Address - Phone:713-863-0114
Mailing Address - Fax:713-863-1653
Practice Address - Street 1:427 W 20TH ST STE 203
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2400
Practice Address - Country:US
Practice Address - Phone:713-863-0114
Practice Address - Fax:713-863-1653
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50644237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB147093OtherPTAN
TX0223935-03Medicaid