Provider Demographics
NPI:1174950026
Name:KADEBYO
Entity type:Organization
Organization Name:KADEBYO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUMGARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:MS/CCC/SLP
Authorized Official - Phone:281-733-4451
Mailing Address - Street 1:2811 PANAGARD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-1858
Mailing Address - Country:US
Mailing Address - Phone:281-733-4451
Mailing Address - Fax:
Practice Address - Street 1:2811 PANAGARD DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-1858
Practice Address - Country:US
Practice Address - Phone:281-733-4451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KADEBYO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-07
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty