Basic Information
| Provider Information | |||||||||
| NPI: | 1093102469 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AVILA | ||||||||
| FirstName: | LUZ | ||||||||
| MiddleName: | MARGARITA | ||||||||
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| Credential: | M.S., CCC/SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8613 CHULA VISTA DR | ||||||||
| Address2: | |||||||||
| City: | MONTE ALTO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785380179 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563551153 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 S JACKSON RD | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566304400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2015 | ||||||||
| LastUpdateDate: | 02/26/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 110048 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.