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General NPI Number Information
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NPI Number | 1700073079
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Entity Type | Organization
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Legal Business Name | FEEDING AND DYSPHAGIA RESOURCES PC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 1105 LIVE OAK DR
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City | PROVIDENCE VILLAGE
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State | TX
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Zip | 76227-5491
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Country | US
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Telephone | 214-538-7328
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2023
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City | DENTON
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State | TX
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Zip | 76202-2023
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Country | US
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Telephone | 940-384-6238
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Fax |
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Authorized Official
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Title or Position | COO
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Name | SUSAN SOWDER
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Credential | CPC, CCP
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Telephone | 940-384-6238
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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 |
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License Number State |
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