Healthcare Provider Details

I. General information

NPI: 1457877540
Provider Name (Legal Business Name): MEGAN LEIGH TAYLOR MS, CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2017
Last Update Date: 07/21/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 SUMMIT ST
SCHULENBURG TX
78956-1532
US

IV. Provider business mailing address

411 SUMMIT ST
SCHULENBURG TX
78956-1532
US

V. Phone/Fax

Practice location:
  • Phone: 979-743-2108
  • Fax:
Mailing address:
  • Phone: 979-743-2108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number113891
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: