| Doctor Name: | TANYA MANRIQUEZ LUJAN |
| NPI Number: | 1457740110 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | 107247 |
| Business Practice Address: | 850 Tower Dr Ste 112 Odessa, TX - 797614252 |
| Business Phone Number: | 4326615405 |
| Business Fax Number: | 4325635582 |
| Mailing Address: | 9315 W 11th St, ODESSA |
| State: | TX |
| Postal Code: | 797637302 |
| Phone Number: | 4326615405 |
| Fax Number: | |
| NPI Enumeration Date: | 01/20/2015 |
| NPI Last Update Date: | 04/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 107247 |
| 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 |