1043736457 NPI number — STARLA HILL SLP-ASSISTANT

Table of content: STARLA HILL SLP-ASSISTANT (NPI 1043736457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043736457 NPI number — STARLA HILL SLP-ASSISTANT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
STARLA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP-ASSISTANT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043736457
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
706 HICKORY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEEN CITY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75572-2517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
AOC 8001 S US HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHERMAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-935-4752
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/17/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2355S0801X , with the licence number:  40114 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)