Provider Demographics
NPI:1205021417
Name:PRECHT, SUSAN GAIL (SLP, M ED)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:GAIL
Last Name:PRECHT
Suffix:
Gender:F
Credentials:SLP, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77562-4125
Mailing Address - Country:US
Mailing Address - Phone:281-426-9194
Mailing Address - Fax:281-426-9194
Practice Address - Street 1:15600 SAN PEDRO AVE
Practice Address - Street 2:STE. 307
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-3740
Practice Address - Country:US
Practice Address - Phone:210-494-2343
Practice Address - Fax:210-545-1657
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist