Provider Demographics
NPI:1336343565
Name:LAWRENCE, KARA BERGMANN (SLP)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:BERGMANN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:JEANNENE
Other - Last Name:BERGMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2501 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-1413
Mailing Address - Country:US
Mailing Address - Phone:512-736-4342
Mailing Address - Fax:
Practice Address - Street 1:2501 AVENUE D
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-1413
Practice Address - Country:US
Practice Address - Phone:512-736-4342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102855235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist