Suzanne M Bastian

Individual provider Active NPI Speech-Language Pathologist · Bryan, TX

NPI 1023770419 · NPPES record last updated Oct 12, 2021

Key facts

NPI
1023770419
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
Practice address
1201 Ridgedale St
Bryan, TX 77803-3722
Phone
(979) 209-2780
NPI assigned
Oct 12, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X TX Yes

Addresses

Primary practice location

1201 Ridgedale St
Bryan, TX 77803-3722

Mailing address

1217 Marsteller Ave
College Station, TX 77840-2518
Phone (979) 229-9104

Other providers in Bryan, TX

All providers in Bryan, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.