Alan Brette Southard, M.S. SLP
Individual provider Active NPI Speech-Language Pathologist · Amherst, TX
NPI 1003036336 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1003036336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 101265 (TX)
- Practice address
- 1400 Main
Amherst, TX 79312 - Phone
- (806) 246-3483
- Fax
- (806) 246-3483
- NPI assigned
- Apr 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101265 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 101265 | TX | Yes |
Addresses
Primary practice location
1400 Main
Amherst, TX 79312
Mailing address
1100 Mockingbird LN
Littlefield, TX 79339-4712
Phone (806) 385-7283
Other providers in Amherst, TX
- Jan Dee Management Services Inc
- Jan Dee Management Services, Inc
- Kelly G Pratt
- Ginda D Level
- Lisa D'Nae Provence
- Shawna Watts
All providers in Amherst, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.