Angie Sue Burdzilauskas

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

NPI 1487908810 · NPPES record last updated Jul 19, 2022

Key facts

NPI
1487908810
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
110920 (TX)
Practice address
733 Meadowcrest Dr
Azle, TX 76020-2544
Phone
(618) 960-9861
NPI assigned
Nov 7, 2012
Sex
Female
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

State licenses

LicenseStateTypeSpecialty
110920TXMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 110920 TX Yes

Addresses

Primary practice location

733 Meadowcrest Dr
Azle, TX 76020-2544

Mailing address

733 Meadowcrest Dr
Azle, TX 76020-2544
Phone (618) 960-9861

Other providers in Azle, TX

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

Sources for this page

Verify at the official NPI Registry.