Healthcare Provider Details

I. General information

NPI: 1538031521
Provider Name (Legal Business Name): MICHELLE THAO-MY VUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 S PRESTON RD
PROSPER TX
75078-3073
US

IV. Provider business mailing address

3801 JEANETTE LN
MCKINNEY TX
75071-2436
US

V. Phone/Fax

Practice location:
  • Phone: 469-214-5898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: