Provider Demographics
NPI:1801095849
Name:A THERATEAM INC
Entity type:Organization
Organization Name:A THERATEAM INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / SPEECH LANGUAGE PATH.
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:VANEK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:936-321-3837
Mailing Address - Street 1:3600 FM 1488 RD
Mailing Address - Street 2:STE. 120
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-3817
Mailing Address - Country:US
Mailing Address - Phone:936-321-3837
Mailing Address - Fax:936-273-3838
Practice Address - Street 1:3600 FM 1488 RD
Practice Address - Street 2:STE. 120
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-3817
Practice Address - Country:US
Practice Address - Phone:936-321-3837
Practice Address - Fax:936-273-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102495235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty