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OUR LADY OF THE LAKE UNIVERSITY NPI 1063622314


NPI Information

NPI: 1063622314
Provider Name: OUR LADY OF THE LAKE UNIVERSITY

Doing Business As: HARRY JERISG CENTER

Classification: Speech-Language Pathologist - 235Z00000X
Entity Type: Organization

CLIA Number: 45D1011389

Address:
411 SW 24TH ST
SAN ANTONIO, TX
ZIP 78207
Phone: (210) 434-6711
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OUR LADY OF THE LAKE UNIVERSITY is a speech language pathologist in San Antonio, TX. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. OUR LADY OF THE LAKE UNIVERSITY NPI is 1063622314. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Harry Jerisg Center.

The provider's business location address is:

411 SW 24TH ST
SAN ANTONIO, TX
ZIP 78207-617
Phone: (210) 434-6711
Fax: (210) 434-9360

The provider's authorized official is Mary Ann Acevedo .
The authorized official title is Director and has the following contact phone number (210) 434-6711.

The CLIA number assigned to this NPI record is 45D1011389 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/23/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1235Z00000XSpeech-Language Pathologist11218TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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