MEDICARE: AVERY CAROLINE BEEDY 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	111817	TX
2	246Q00000X	Pathology Specialist/Technologist	111817	TX

General Provider Information

NPI Number	:	1861112724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVERY CAROLINE BEEDY SLP

Provider Business Mailing Address
First Line	:	5807 E UNIVERSITY BLVD APT D
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-4610
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 HARVEST HILL RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-1684
Country	:	US
Telephone Number	:	972-366-7374
Fax Number	:

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

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	03/02/2026

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Directions to “ AVERY CAROLINE BEEDY SLP” Practice Location

Language	Start Address	Practice Location

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