Provider Demographics
NPI:1043704778
Name:BAUMGARTNER, TANYA LILLY (MS)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:LILLY
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 N IH 35
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2817
Mailing Address - Country:US
Mailing Address - Phone:830-221-2000
Mailing Address - Fax:
Practice Address - Street 1:3201 CHERRY RIDGE ST STE D400
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4820
Practice Address - Country:US
Practice Address - Phone:210-693-0222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-16
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX370402355S0801X
TX14396054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant