Provider Demographics
NPI:1174768030
Name:PADILLA, MARCELA (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARCELA
Middle Name:
Last Name:PADILLA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502 STACKSTONE LN
Mailing Address - Street 2:APT 2
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6722
Mailing Address - Country:US
Mailing Address - Phone:201-213-2461
Mailing Address - Fax:832-644-0127
Practice Address - Street 1:2026 WIRT RD
Practice Address - Street 2:SUITE 103B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-1626
Practice Address - Country:US
Practice Address - Phone:201-213-2461
Practice Address - Fax:832-644-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-06
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106798235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist