Provider Demographics
NPI:1992050678
Name:ANZALDUA, NAYRA LEE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NAYRA
Middle Name:LEE
Last Name:ANZALDUA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:NAYRA
Other - Middle Name:LEE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:538 S SHOWERS RD
Mailing Address - Street 2:
Mailing Address - City:PALMVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:78572-7812
Mailing Address - Country:US
Mailing Address - Phone:956-458-2993
Mailing Address - Fax:956-587-0245
Practice Address - Street 1:538 S SHOWERS RD
Practice Address - Street 2:
Practice Address - City:PALMVIEW
Practice Address - State:TX
Practice Address - Zip Code:78572-7812
Practice Address - Country:US
Practice Address - Phone:956-458-2993
Practice Address - Fax:956-587-0245
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109165235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist