Basic Information
| Provider Information | |||||||||
| NPI: | 1699141572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAO | ||||||||
| FirstName: | TABITHA | ||||||||
| MiddleName: | HSIUNEN | ||||||||
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| Credential: | MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1202 S FM 116 APT 5207 | ||||||||
| Address2: | |||||||||
| City: | COPPERAS COVE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765223647 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9405369513 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2300 S CLEAR CREEK RD STE 102 | ||||||||
| Address2: | |||||||||
| City: | KILLEEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 76549 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2545542637 | ||||||||
| FaxNumber: | 2545546606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2015 | ||||||||
| LastUpdateDate: | 08/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 111678 | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.