Provider Demographics
NPI:1801524731
Name:TAMAYO, FRANCISCA (MA CCC/SLP)
Entity type:Individual
Prefix:
First Name:FRANCISCA
Middle Name:
Last Name:TAMAYO
Suffix:
Gender:F
Credentials:MA 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:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:LYTLE
Mailing Address - State:TX
Mailing Address - Zip Code:78052-0712
Mailing Address - Country:US
Mailing Address - Phone:210-740-9069
Mailing Address - Fax:
Practice Address - Street 1:18930 PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052-3479
Practice Address - Country:US
Practice Address - Phone:210-416-6331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist