Healthcare Provider Details

I. General information

NPI: 1710881701
Provider Name (Legal Business Name): CHRISTINE MCPHAN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 S CENTRE AVE
LANCASTER TX
75146-3829
US

IV. Provider business mailing address

1514 FOREST CREEK DR
CEDAR HILL TX
75104-5719
US

V. Phone/Fax

Practice location:
  • Phone: 817-709-7985
  • Fax:
Mailing address:
  • Phone: 817-709-7985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number36855
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: