Provider Demographics
NPI:1679143143
Name:HEPWORTH, BENJAMIN PAUL I (CF-CCC SLP)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:PAUL
Last Name:HEPWORTH
Suffix:I
Gender:M
Credentials:CF-CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75146-1077
Mailing Address - Country:US
Mailing Address - Phone:817-876-8729
Mailing Address - Fax:
Practice Address - Street 1:2011 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5797
Practice Address - Country:US
Practice Address - Phone:817-345-7530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist