Provider Demographics
NPI:1881700359
Name:ZACHARIAH, ANITA (EDD, MS, CCC-SLP, A)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:ZACHARIAH
Suffix:
Gender:
Credentials:EDD, MS, CCC-SLP, A
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:NAOMI
Other - Last Name:KIRBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:EDD, MS, CCC-SLP, A
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:604 ROBERT STREET
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092
Practice Address - Country:US
Practice Address - Phone:713-294-2661
Practice Address - Fax:281-292-8696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162363901Medicaid
TX8T3682OtherBLUE SHIELD PROVIDER I D