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NPI Code Detail

MEDICARE: MATTHEW WOOLDRIDGE MS CCC-SLP

MEDICARE: MATTHEW WOOLDRIDGE MS CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist115305TX

General Provider Information

NPI Number : 1174478051
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW WOOLDRIDGE MS CCC-SLP
Provider Business Mailing Address
First Line : 5502 BURGUNDY DR
Second Line :
City : AUSTIN
State : TX
Zip : 78724-3306
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 330 W BEN WHITE BLVD
Second Line :
City : AUSTIN
State : TX
Zip : 78704-8095
Country : US
Telephone Number : 512-217-6861
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ MATTHEW WOOLDRIDGE MS CCC-SLP” Practice Location

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