Provider Demographics
NPI:1366834368
Name:SIGNATURE TALK OF WEST TEXAS LLC
Entity type:Organization
Organization Name:SIGNATURE TALK OF WEST TEXAS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGAUGE PATHOLOGIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-201-7701
Mailing Address - Street 1:14637 GINGER KERRICK
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-1018
Mailing Address - Country:US
Mailing Address - Phone:915-201-7701
Mailing Address - Fax:
Practice Address - Street 1:14637 GINGER KERRICK
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-1018
Practice Address - Country:US
Practice Address - Phone:915-201-7701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101417251E00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty