Provider Demographics
NPI:1356532154
Name:JUAREZ, JESSICA KRISTEN (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:KRISTEN
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2901 MONTOPOLIS DR
Mailing Address - Street 2:AUDIOLOGY DEPARTMENT
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6411
Mailing Address - Country:US
Mailing Address - Phone:512-389-6505
Mailing Address - Fax:512-389-6559
Practice Address - Street 1:2901 MONTOPOLIS DR
Practice Address - Street 2:AUDIOLOGY DEPARTMENT
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-6411
Practice Address - Country:US
Practice Address - Phone:512-389-6505
Practice Address - Fax:512-389-6559
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80072231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist