Jessica Cano, M.A., SLP-CCC

Individual provider Active NPI Speech-Language Pathologist · San Elizario, TX

NPI 1154772523 · NPPES record last updated Mar 9, 2017

Key facts

NPI
1154772523
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
111473 (TX)
Practice address
1433 Tula CT
San Elizario, TX 79849-0137
Phone
(915) 820-2889
NPI assigned
Jun 28, 2016
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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 Arts

State licenses

LicenseStateTypeSpecialty
111473TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun City Speech Therapy, LLC Speech-Language Pathologist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 111473 TX Yes

Addresses

Primary practice location

1433 Tula CT
San Elizario, TX 79849-0137

Mailing address

PO Box 137
San Elizario, TX 79849-0137
Phone (915) 820-2889

Other providers in San Elizario, TX

All providers in San Elizario, TX · Speech-Language Pathologist in Texas

Sources for this page

Verify at the official NPI Registry.