MEDICARE: KINETIC SPEECH SERVICES, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2355S0801X	Speech-Language Assistant
2	225100000X	Physical Therapist
3	225X00000X	Occupational Therapist
4	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1669169694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINETIC SPEECH SERVICES, PLLC

Provider Business Mailing Address
First Line	:	2880 BROADWAY BEND DR BLDG 3
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-2575
Country	:	US
Telephone Number	:	512-689-9291
Fax Number	:	877-920-2116

Provider Business Practice Location Address
First Line	:	2880 BROADWAY BEND DR BLDG 3
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-2575
Country	:	US
Telephone Number	:	832-278-1955
Fax Number	:	877-920-2116

Authorized Official
Title or Position	:	OWNER/SPEECH-LANGUAGE PATHOLOGIST
Name	:	TIFFANY FAIRDOSI
Credential	:	M.S., CCC-SLP
Telephone Number	:	512-689-9291

Provider Enumeration Date	:	04/19/2023
Last Update Date	:	03/16/2026

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Directions to “KINETIC SPEECH SERVICES, PLLC ” Practice Location

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