Basic Information
| Provider Information | |||||||||
| NPI: | 1255967568 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DURNFORD | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 UNIVERSAL CITY BLVD | ||||||||
| Address2: | |||||||||
| City: | UNIVERSAL CITY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781483317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103361524 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1019 DELL DALE ST | ||||||||
| Address2: | |||||||||
| City: | CHANNELVIEW | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775302409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2103508800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2020 | ||||||||
| LastUpdateDate: | 10/17/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | RBT-18-63050 | TX | N | 193400000X SINGLE SPECIALTY GROUP | 235Z00000X | 118976 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.