Provider Demographics
NPI:1386054138
Name:RAYITO DE SOL SPEECH THERAPY
Entity type:Organization
Organization Name:RAYITO DE SOL SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KARINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:TANGUMA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:956-581-7172
Mailing Address - Street 1:2105 W 3 MILE RD
Mailing Address - Street 2:STE. 4
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78573-6732
Mailing Address - Country:US
Mailing Address - Phone:956-581-7172
Mailing Address - Fax:956-581-7130
Practice Address - Street 1:2105 W 3 MILE RD
Practice Address - Street 2:STE. 4
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78573-6732
Practice Address - Country:US
Practice Address - Phone:956-581-7172
Practice Address - Fax:956-581-7130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty