# GULF COAST SPEECH PATHOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gulf Coast Therapy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417431461
- **Authorized official:** JULIE MARY BONOMO (ADMINISTRATOR)
- **Authorized official phone:** (409) 242-6500

## Contact information

- **Practice address:** 928 BROADWAY ST, GALVESTON, TX 77550-6228
- **Practice address phone:** (409) 242-6500
- **Practice address fax:** (409) 497-4389
- **Mailing address:** PO BOX 57, GALVESTON, TX 77553-0057
- **Mailing address phone:** (409) 242-6500
- **Mailing address fax:** (409) 497-4389

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 09/17/2018