MEDICARE: ELIZABETH MARIE SAMPSON M.A., 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
1	235Z00000X	Speech-Language Pathologist	105968	TX

General Provider Information

NPI Number	:	1396471389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH MARIE SAMPSON M.A., CCC/SLP

Provider Business Mailing Address
First Line	:	699 S FRIENDSWOOD DR STE 104
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-4580
Country	:	US
Telephone Number	:	281-816-3067
Fax Number	:	832-569-4696

Provider Business Practice Location Address
First Line	:	820 S FRIENDSWOOD DR STE 100
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-4543
Country	:	US
Telephone Number	:	281-816-3067
Fax Number	:	832-569-4696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	11/08/2024

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Directions to “ ELIZABETH MARIE SAMPSON M.A., CCC/SLP” Practice Location

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