Gandara, Suomi Lopez

Gandara, Suomi Lopez is an individual health care provider with primary practice located at 5316 Trail Lake Dr , Fort Worth TX 76133-1931. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiology Assistant, which is considered as her primary health care specialty. Gandara, Suomi Lopez can be contacted via phone (817) 292-8787.

Contact Information

Primary practice address
5316 Trail Lake Dr Fort Worth TX 76133-1931
Phone: (817) 292-8787
Fax: (817) 789-6849
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiology Assistant 2355A2700X 35232 Texas

Profile Details

NPI number 1295065480
LBN Legal business name Gandara, Suomi Lopez
Credentials SLP-A
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2010
Last updated Jan 11th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295065480 NPPES
Texas MEDICAID 149984001

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