Provider Demographics
NPI:1932603636
Name:TELLO, PATRICIA GARZA
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:GARZA
Last Name:TELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:GARZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, ASSISTANT-SLP
Mailing Address - Street 1:3802 PALO SOLO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3852
Mailing Address - Country:US
Mailing Address - Phone:210-273-3865
Mailing Address - Fax:
Practice Address - Street 1:3802 PALO SOLO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3852
Practice Address - Country:US
Practice Address - Phone:210-273-3865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX342322355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant