Provider Demographics
NPI:1568714251
Name:IZAGUIRRE, ALFREDO (SLP)
Entity type:Individual
Prefix:
First Name:ALFREDO
Middle Name:
Last Name:IZAGUIRRE
Suffix:
Gender:
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 W 14TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-3618
Mailing Address - Country:US
Mailing Address - Phone:956-975-5329
Mailing Address - Fax:
Practice Address - Street 1:327 W 3RD ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-3105
Practice Address - Country:US
Practice Address - Phone:956-565-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109364235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist