Provider Demographics
NPI:1063720688
Name:FLORES CABEZA, FABIOLA (MS, CC-SLP)
Entity type:Individual
Prefix:MRS
First Name:FABIOLA
Middle Name:
Last Name:FLORES CABEZA
Suffix:
Gender:F
Credentials:MS, CC-SLP
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:
Other - Last Name:CABEZA DE FLORES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CC-SLP
Mailing Address - Street 1:6550 SPRINFIELD AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-6712
Mailing Address - Country:US
Mailing Address - Phone:956-725-4555
Mailing Address - Fax:956-725-3555
Practice Address - Street 1:6550 SPRINGFIELD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-6712
Practice Address - Country:US
Practice Address - Phone:956-725-4555
Practice Address - Fax:956-725-3555
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist