Basic Information
Provider Information
NPI: 1336254200
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILYER
FirstName: TAMELA
MiddleName: HALE
NamePrefix:  
NameSuffix:  
Credential: CCC/SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2304 BRENNAN DR
Address2:  
City: PLANO
State: TX
PostalCode: 750756618
CountryCode: US
TelephoneNumber: 9723982454
FaxNumber:  
Practice Location
Address1: 1201 E 15TH ST
Address2:  
City: PLANO
State: TX
PostalCode: 750746238
CountryCode: US
TelephoneNumber: 9724240148
FaxNumber: 9724225275
Other Information
ProviderEnumerationDate: 08/20/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X18982TXY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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