=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417806050
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAKSHMI NATHAN SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2026
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2301 N BROOK DR
-----------------------------------------------------
City | MCKINNEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75072-3854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-964-6299
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 401 FAIRLAND DR
-----------------------------------------------------
City | WYLIE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75098-5089
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-964-6299
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 106554
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------