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Organization
SPEECH FOR PETITES, LLC
Active
Organization
SPEECH FOR PETITES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAN LUONG CCC-SLP (OWNER)
(316) 519-1795
Entity
Organization
Contact information
Practice address
1100 HERCULES AVE STE 100, HOUSTON, TX 77058-2797
(316) 519-1795
Mailing address
4413 KOEHLER ST UNIT E, HOUSTON, TX 77007-3592
(316) 519-1795
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417497884
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/15/2023
Last updated
05/10/2023
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