Doctor Name: | ALAN BRETTE SOUTHARD |
NPI Number: | 1003036336 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S. SLP |
License Number: | 101265 |
Business Practice Address: | 1400 Main Amherst, TX - 79312 |
Business Phone Number: | 8062463483 |
Business Fax Number: | 8062463483 |
Mailing Address: | 1100 Mockingbird Ln, LITTLEFIELD |
State: | TX |
Postal Code: | 793394712 |
Phone Number: | 8063857283 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 101265 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |