Basic Information
| Provider Information | |||||||||
| NPI: | 1194239020 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PATE | ||||||||
| FirstName: | TIONA | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 111878 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 772930878 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133202670 | ||||||||
| FaxNumber: | 7135837597 | ||||||||
| Practice Location | |||||||||
| Address1: | 2656 S LOOP W STE 170 | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770542664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133202670 | ||||||||
| FaxNumber: | 7135837597 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2017 | ||||||||
| LastUpdateDate: | 11/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 112468 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.