Provider Demographics
NPI:1962946368
Name:DE LA GARZA, LYANN RUBI (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LYANN
Middle Name:RUBI
Last Name:DE LA GARZA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5947
Mailing Address - Country:US
Mailing Address - Phone:956-755-7301
Mailing Address - Fax:
Practice Address - Street 1:3800 N LAMAR BLVD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-0003
Practice Address - Country:US
Practice Address - Phone:512-399-0064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-05
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112789235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist