Basic Information
| Provider Information | |||||||||
| NPI: | 1194445742 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOWARD | ||||||||
| FirstName: | RECO | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1628 19TH ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794014832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067825744 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1628 19TH ST | ||||||||
| Address2: | |||||||||
| City: | LUBBOCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 794014832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8062190500 | ||||||||
| FaxNumber: | 8067661286 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2022 | ||||||||
| LastUpdateDate: | 09/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 118767 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
ID Information
| ID | Type | State | Issuer | Description | 118767 | 01 | TX | PROFESSIONAL LICENSE | OTHER |