Provider Demographics
NPI:1215253141
Name:S & L PEDIATRIC THERAPY SERVICES LLC
Entity type:Organization
Organization Name:S & L PEDIATRIC THERAPY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-630-6112
Mailing Address - Street 1:5211 N. MCCOLL ROAD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2202
Mailing Address - Country:US
Mailing Address - Phone:956-630-6112
Mailing Address - Fax:956-683-9504
Practice Address - Street 1:5211 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2202
Practice Address - Country:US
Practice Address - Phone:956-630-6112
Practice Address - Fax:956-683-9504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18609235Z00000X
TX103428235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty