Provider Demographics
NPI:1598584385
Name:SPERO MYOFUNCTIONAL THERAPY LLC
Entity type:Organization
Organization Name:SPERO MYOFUNCTIONAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OROFACIAL MYOFUNCTIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JULI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:832-298-3490
Mailing Address - Street 1:28911 YAUPON TRACE DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1903
Mailing Address - Country:US
Mailing Address - Phone:832-298-3490
Mailing Address - Fax:
Practice Address - Street 1:28911 YAUPON TRACE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1903
Practice Address - Country:US
Practice Address - Phone:832-298-3490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty