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Organization
THERADAT, LLC
Active
Organization
THERADAT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA ANDREA NALL M.S., CCC-SLP (SPEECH LANGUAGE PATHOLOGIST)
(254) 722-6660
Entity
Organization
Contact information
Practice address
7545 BOSQUE BLVD, WACO, TX 76712-3713
(254) 722-6660
Mailing address
PO BOX 9090, WACO, TX 76714-9090
(254) 722-6660
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
Primary
16247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162082501
—
TX
Enumeration date
05/07/2007
Last updated
08/13/2008
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