Provider Demographics
NPI:1801912977
Name:PARRY, CONSUELO MONICA
Entity type:Individual
Prefix:
First Name:CONSUELO
Middle Name:MONICA
Last Name:PARRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11113 FIDDLENECK ST
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3504
Mailing Address - Country:US
Mailing Address - Phone:321-443-7059
Mailing Address - Fax:
Practice Address - Street 1:1014 N STANTON ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-4109
Practice Address - Country:US
Practice Address - Phone:321-443-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24778235Z00000X
FLSA13501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist