1265101828 NPI number — LYNETTE MARY MAJOR SPEECH PATHOLOGIST

Table of content: LYNETTE MARY MAJOR SPEECH PATHOLOGIST (NPI 1265101828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265101828 NPI number — LYNETTE MARY MAJOR SPEECH PATHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAJOR
Provider First Name:
LYNETTE
Provider Middle Name:
MARY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SPEECH PATHOLOGIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MAJOR
Provider Other First Name:
MARY
Provider Other Middle Name:
LYNETTE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
SPEECH PATHOLOGIST
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1265101828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SOUTH PLAINS EDUCATIONAL COOP
Provider Second Line Business Mailing Address:
704 11TH ST.
Provider Business Mailing Address City Name:
LEVELLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79336
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-894-6858
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SOUTH PLAINS EDUCATIONAL COOP
Provider Second Line Business Practice Location Address:
704 11TH ST.
Provider Business Practice Location Address City Name:
LEVELLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79336
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
806-894-6858
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2021

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: 235Z00000X , with the licence number:  11728 , 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)





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