Provider Demographics
NPI:1114781804
Name:ANDERSON SPEECH THERAPY, LLC
Entity type:Organization
Organization Name:ANDERSON SPEECH THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-645-2500
Mailing Address - Street 1:8911 GILL BRG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-4912
Mailing Address - Country:US
Mailing Address - Phone:936-645-2500
Mailing Address - Fax:
Practice Address - Street 1:4939 DE ZAVALA RD STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-2001
Practice Address - Country:US
Practice Address - Phone:210-239-3103
Practice Address - Fax:214-785-3447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty