Provider Demographics
NPI:1265150239
Name:PULIDO, ELIZABETH (M S , CCC - SLP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PULIDO
Suffix:
Gender:F
Credentials:M S , CCC - SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 SANDPIPER AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-1760
Mailing Address - Country:US
Mailing Address - Phone:956-566-9843
Mailing Address - Fax:
Practice Address - Street 1:2185 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-8451
Practice Address - Country:US
Practice Address - Phone:956-632-3285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103471235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist