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General NPI Number Information
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NPI Number | 1033920525
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Entity Type | Individual
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Provider Name | MACY MCCOY
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 7301 CANYON PARK DR UNIT 100
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City | FORT WORTH
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State | TX
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Zip | 76123-3038
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Country | US
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Telephone | 817-479-7019
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Fax |
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Provider Business Mailing Address
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Address Line | 6168 BENTRIDGE DR
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City | HURST
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State | TX
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Zip | 76054-2615
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 123337
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License Number State | TX
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