Provider Demographics
NPI:1174746093
Name:COASTAL BEND SPEECH AND LANGUAGE ASSOCIATES
Entity type:Organization
Organization Name:COASTAL BEND SPEECH AND LANGUAGE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:EILEEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:VARA
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:361-814-4600
Mailing Address - Street 1:3765 S ALAMEDA ST
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1643
Mailing Address - Country:US
Mailing Address - Phone:361-814-4600
Mailing Address - Fax:361-814-4610
Practice Address - Street 1:3765 S ALAMEDA ST
Practice Address - Street 2:SUITE 320
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1643
Practice Address - Country:US
Practice Address - Phone:361-814-4600
Practice Address - Fax:361-814-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty