Basic Information
Provider Information
NPI: 1376946475
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VASQUEZ
FirstName: CLAUDIA
MiddleName: YVETTE
NamePrefix:  
NameSuffix:  
Credential: M.S., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1900 S JACKSON RD STE 2AND3
Address2:  
City: MCALLEN
State: TX
PostalCode: 785031588
CountryCode: US
TelephoneNumber: 9566304440
FaxNumber: 9566304447
Practice Location
Address1: 301 LORENALY DR STE A
Address2:  
City: BROWNSVILLE
State: TX
PostalCode: 785264446
CountryCode: US
TelephoneNumber: 9563506696
FaxNumber: 9563506604
Other Information
ProviderEnumerationDate: 10/02/2014
LastUpdateDate: 10/02/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X109951TXY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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