Provider Demographics
NPI:1548890973
Name:E-INTEGRATED SLP SERVICES, PLLC
Entity type:Organization
Organization Name:E-INTEGRATED SLP SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-762-2666
Mailing Address - Street 1:464 WHISPERING WIND WAY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78737-4718
Mailing Address - Country:US
Mailing Address - Phone:512-762-2666
Mailing Address - Fax:
Practice Address - Street 1:464 WHISPERING WIND WAY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78737-4718
Practice Address - Country:US
Practice Address - Phone:512-762-2666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech