Provider Demographics
NPI:1154825370
Name:MILLAN, SAN JUANITA A (MS, SLP-CF)
Entity type:Individual
Prefix:
First Name:SAN JUANITA
Middle Name:A
Last Name:MILLAN
Suffix:
Gender:F
Credentials:MS, SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GESSNER RD STE 190
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3844
Mailing Address - Country:US
Mailing Address - Phone:713-996-7996
Mailing Address - Fax:713-996-7591
Practice Address - Street 1:2600 GESSNER RD STE 190
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3844
Practice Address - Country:US
Practice Address - Phone:713-996-7996
Practice Address - Fax:713-996-7591
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist