Healthcare Provider Details

I. General information

NPI: 1962815092
Provider Name (Legal Business Name): JAIME BAILEY M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6168 BENTRIDGE DR
HURST TX
76054-2615
US

IV. Provider business mailing address

6168 BENTRIDGE DR
HURST TX
76054-2615
US

V. Phone/Fax

Practice location:
  • Phone: 214-682-7714
  • Fax:
Mailing address:
  • Phone: 817-292-8787
  • Fax: 817-789-6849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number104207
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: