Provider Demographics
NPI:1194904003
Name:NAVA, ANDREA LELA (AUD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LELA
Last Name:NAVA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-5823
Mailing Address - Country:US
Mailing Address - Phone:806-799-8950
Mailing Address - Fax:806-799-8939
Practice Address - Street 1:1005 W WALL ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6637
Practice Address - Country:US
Practice Address - Phone:432-687-2955
Practice Address - Fax:432-687-0410
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80111231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1765976Medicaid
TX80111OtherBOARD OF SLP & AUDIOLOGY
TX80111OtherBOARD OF SLP & AUDIOLOGY