Basic Information
| Provider Information | |||||||||
| NPI: | 1649495169 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BOBBYE RECORDS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2050 GREENWOOD DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760928354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178651161 | ||||||||
| FaxNumber: | 8663008627 | ||||||||
| Practice Location | |||||||||
| Address1: | 2050 GREENWOOD DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SOUTHLAKE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760928360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8178651161 | ||||||||
| FaxNumber: | 8663008627 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 05/15/2014 | ||||||||
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| AuthorizedOfficialLastName: | RECORDS | ||||||||
| AuthorizedOfficialFirstName: | BOBBYE | ||||||||
| AuthorizedOfficialMiddleName: | RUTH | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8178651161 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | CCC/SLP | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 13009 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.