Provider Demographics
NPI:1962665901
Name:LEAL-GARZA, BELLA L (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:BELLA
Middle Name:L
Last Name:LEAL-GARZA
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 E GRIFFIN PKWY
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2408
Mailing Address - Country:US
Mailing Address - Phone:956-432-0113
Mailing Address - Fax:956-432-0115
Practice Address - Street 1:1112 E GRIFFIN PKWY STC C
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2408
Practice Address - Country:US
Practice Address - Phone:956-432-0113
Practice Address - Fax:956-432-0115
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11553235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist