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Contact Information

409 THERAPY SERVICES, PLLC
139 PRIVATE ROAD 5396
KIRBYVILLE, TX75956-3235
 Phone: 409-449-5498
 Fax: 409-449-6079
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for 409 THERAPY SERVICES, PLLC

NPI # 1972240166
LBN Legal business name 409 THERAPY SERVICES, PLLC
Authorized official JESSICA PETTY - (OWNER / OPERATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/18/2022
Last updated 06/27/2022 - About 4 years ago
Identifiers
TX Medicaid 1457784167
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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