Bahola Puentes Polo, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

101174 Issued in TX

Practice address

2431 Arizona Ave
El Paso, TX 79930-1008

Phone

(915) 544-8381

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1316068059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 ARIZONA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799301008",
            "telephone_number": "915-544-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 ARIZONA AVE",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799301008",
            "telephone_number": "915-544-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUENTES POLO",
        "first_name": "BAHOLA",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173039201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Psychiatric Professionals of El Paso PA
• PT Home Services of San Antonio, Inc.
• PT OT Connect
• Pueblo de Salud Home Health Services LLC
• Sofia Puente
• Adriana Michelle Puentes, MSN, APRN, AGACNP-BC
• Krystal Angelica Puentes
• Itzel Puertas Garcia
• James Patrick Pufal
• Johanna Yvette Puga-Martinez

• Speech-Language Pathologist in El Paso, TX
• Providers in El Paso, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.