Provider Demographics
NPI:1386882389
Name:BILINGUAL SPEECH THERAPY OF HOUSTON
Entity type:Organization
Organization Name:BILINGUAL SPEECH THERAPY OF HOUSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:713-429-1176
Mailing Address - Street 1:9894 BISSONNET
Mailing Address - Street 2:SUITE 388
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-429-1176
Mailing Address - Fax:832-252-9263
Practice Address - Street 1:6666 HARWIN DR STE 158
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2546
Practice Address - Country:US
Practice Address - Phone:713-429-1176
Practice Address - Fax:832-252-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102518235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX451624701Medicaid
TX451624702Medicaid