Provider Demographics
NPI:1972871267
Name:SIFUENTES, RAMON O (SLPA)
Entity type:Individual
Prefix:MR
First Name:RAMON
Middle Name:O
Last Name:SIFUENTES
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 MARTHA ST
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589
Mailing Address - Country:US
Mailing Address - Phone:956-227-1776
Mailing Address - Fax:
Practice Address - Street 1:410 MARTHA ST
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-4996
Practice Address - Country:US
Practice Address - Phone:956-227-1776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX364362355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant