Provider Demographics
NPI:1356038947
Name:TEXAS ELITE THERAPY TEAM LLC
Entity type:Organization
Organization Name:TEXAS ELITE THERAPY TEAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOM
Authorized Official - Suffix:
Authorized Official - Credentials:MA CCC-SLP
Authorized Official - Phone:361-772-2401
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:HALLETTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77964-0166
Mailing Address - Country:US
Mailing Address - Phone:361-210-7366
Mailing Address - Fax:361-799-5001
Practice Address - Street 1:107 S JUDY ST
Practice Address - Street 2:
Practice Address - City:HALLETTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77964-3223
Practice Address - Country:US
Practice Address - Phone:361-210-7366
Practice Address - Fax:361-799-5001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty