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General NPI Number Information
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NPI Number | 1265671416
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Entity Type | Individual
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Provider Name | DANA L MANGUS SLP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2009
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Last Update Date | 09/20/2012
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Provider Practice Location Address
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Address Line | 190 CIVIC CIR STE 250
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City | LEWISVILLE
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State | TX
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Zip | 75067-3424
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Country | US
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Telephone | 972-786-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 3612 WESTMINISTER TRL
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City | FLOWER MOUND
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State | TX
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Zip | 75022-2943
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Country | US
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Telephone | 972-358-1518
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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 | 100924
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License Number State | TX
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