Provider Demographics
NPI:1316426042
Name:FALCON, CELIN
Entity type:Individual
Prefix:
First Name:CELIN
Middle Name:
Last Name:FALCON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 REDSKIN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:DONNA
Mailing Address - State:TX
Mailing Address - Zip Code:78537-3380
Mailing Address - Country:US
Mailing Address - Phone:956-358-6774
Mailing Address - Fax:
Practice Address - Street 1:2010 REDSKIN AVE STE B
Practice Address - Street 2:
Practice Address - City:DONNA
Practice Address - State:TX
Practice Address - Zip Code:78537-3380
Practice Address - Country:US
Practice Address - Phone:956-358-6774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX350042355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780619031Medicaid