Provider First Line Business Practice Location Address: 
601 UNIVERSITY DR TEXAS STATE UNIVERSITY SAN MARCOS
    Provider Second Line Business Practice Location Address: 
SPEECH LANGUAGE HEARING CLINIC
    Provider Business Practice Location Address City Name: 
SAN MARCOS
    Provider Business Practice Location Address State Name: 
TX
    Provider Business Practice Location Address Postal Code: 
78666
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
512-245-8241
    Provider Business Practice Location Address Fax Number: 
512-245-9640
    Provider Enumeration Date: 
09/16/2006