Provider Demographics
NPI:1255779153
Name:XCEPTIONAL THERAPY P.C.
Entity type:Organization
Organization Name:XCEPTIONAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MA,CCC-SLP
Authorized Official - Phone:713-562-1980
Mailing Address - Street 1:1717 TURNING BASIN DR
Mailing Address - Street 2:SUITE #385
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77029-4050
Mailing Address - Country:US
Mailing Address - Phone:713-360-7430
Mailing Address - Fax:713-360-7431
Practice Address - Street 1:1717 TURNING BASIN DR
Practice Address - Street 2:SUITE #385
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77029-4050
Practice Address - Country:US
Practice Address - Phone:713-360-7430
Practice Address - Fax:713-360-7431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-13
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty