Basic Information
| Provider Information | |||||||||
| NPI: | 1447224258 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPEZ | ||||||||
| FirstName: | GILDA | ||||||||
| MiddleName: | TREVINO | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MS CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 413 W YUCCA AVE | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566873675 | ||||||||
| FaxNumber: | 9566863738 | ||||||||
| Practice Location | |||||||||
| Address1: | 612 NOLANA ST | ||||||||
| Address2: | STE 540 | ||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566304400 | ||||||||
| FaxNumber: | 9566304447 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 102299 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.