Individual ProviderJanice M LongoriaSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address4206 Retama Cir, Victoria, TX 77901-2765(361) 582-0611PECOS EnrollmentBased on the most recent information from CMS, provider Janice M Longoria does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1962439729Provider TypeIndividualFull NameLongoria, Janice MTitleMrs.CredentialSLPGenderFemaleSole ProprietorNoEnumeration Date6/27/2006Last Updated7/15/2009Contact InformationPractice LocationPractice Address4206 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Mailing LocationMailing Address4206 Retama Cir, Victoria, TX 77901-2765Phone(361) 582-0611Fax(361) 582-0555Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense13426TexasProvider IdentifiersIDDescriptionIssuerID164704201DescriptionMedicaidIssuerUnlistedTexas