Provider Demographics
NPI:1134844897
Name:SERRANO-VELEZ, MARIEL
Entity type:Individual
Prefix:
First Name:MARIEL
Middle Name:
Last Name:SERRANO-VELEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5235 GERENT LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-3243
Mailing Address - Country:US
Mailing Address - Phone:281-763-6206
Mailing Address - Fax:
Practice Address - Street 1:6301 S STADIUM LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1057
Practice Address - Country:US
Practice Address - Phone:281-396-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist