| Doctor Name: | MR. CHARLES BIRD |
| NPI Number: | 1063882215 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 110618 |
| Business Practice Address: | 3721 Executive Center Dr #201 Austin, TX - 787311645 |
| Business Phone Number: | 5123723777 |
| Business Fax Number: | 5123723336 |
| Mailing Address: | 305 Ne Loop 820, Business Tower 1, Suite 200 HURST |
| State: | TX |
| Postal Code: | 760537209 |
| Phone Number: | 8172928787 |
| Fax Number: | 8177896849 |
| NPI Enumeration Date: | 09/30/2015 |
| NPI Last Update Date: | 09/30/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 110618 |
| 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 |