Organization
BEACON THERAPY RESOURCE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHRYN FERNANDEZ CCC-SLP (OWNER/SLP)
(830) 773-2400
Entity
Organization
Contact information
Practice address
342 E RIO GRANDE ST, SUITE A, EAGLE PASS, TX 78852-4812
(830) 773-2400
(830) 773-8020
Mailing address
342 E RIO GRANDE ST, SUITE A, EAGLE PASS, TX 78852-4812
(830) 773-2400
(830) 773-8020
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17977
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170523803
—
TX
Enumeration date
03/28/2012
Last updated
03/28/2012
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