Basic Information
Provider Information
NPI: 1619396975
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PANATEX-DELAFUENTE
FirstName: APRIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: SLPA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8613 PILGRIMAGE CIR
Address2:  
City: EL PASO
State: TX
PostalCode: 799121361
CountryCode: US
TelephoneNumber: 9153834390
FaxNumber:  
Practice Location
Address1: 6601 MONTANA AVE
Address2:  
City: EL PASO
State: TX
PostalCode: 799252155
CountryCode: US
TelephoneNumber: 9148387604
FaxNumber: 9157724633
Other Information
ProviderEnumerationDate: 04/15/2014
LastUpdateDate: 04/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2355S0801X37734TXY Speech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant

No ID Information.


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