Provider Demographics
NPI:1285077149
Name:PATEL, MUNIBA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MUNIBA
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 N SAM HOUSTON PKWY E
Mailing Address - Street 2:#199
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:340 N SAM HOUSTON PKWY E
Practice Address - Street 2:#199
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3305
Practice Address - Country:US
Practice Address - Phone:281-822-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist