| Doctor Name: | VANNESA MARIE ELIZONDO |
| NPI Number: | 1093084212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP-CCC |
| License Number: | 102439 |
| Business Practice Address: | 700 E Bravo Blvd Ste C Roma, TX - 785845742 |
| Business Phone Number: | 9568493703 |
| Business Fax Number: | 9568493735 |
| Mailing Address: | 1814 E Griffin Pkwy, MISSION |
| State: | TX |
| Postal Code: | 785723105 |
| Phone Number: | 9565192500 |
| Fax Number: | 9565192520 |
| NPI Enumeration Date: | 12/16/2011 |
| NPI Last Update Date: | 12/16/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 102439 |
| 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 |