Provider Demographics
NPI:1649495169
Name:BOBBYE RECORDS LLC
Entity type:Organization
Organization Name:BOBBYE RECORDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBYE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:RECORDS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:817-865-1161
Mailing Address - Street 1:2050 GREENWOOD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-8354
Mailing Address - Country:US
Mailing Address - Phone:817-865-1161
Mailing Address - Fax:866-300-8627
Practice Address - Street 1:2050 GREENWOOD DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-8360
Practice Address - Country:US
Practice Address - Phone:817-865-1161
Practice Address - Fax:866-300-8627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13009235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty