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General NPI Number Information
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NPI Number | 1972384048
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Entity Type | Individual
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Provider Name | RAYGAN OLDFIELD
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Gender | Female
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Dates
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Enumeration Date | 10/13/2023
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 2725 BRYANT FARM RD
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City | ANNA
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State | TX
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Zip | 75409
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Country | US
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Telephone | 972-924-1813
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Fax |
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Provider Business Mailing Address
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Address Line | 2900 CROSSBOW LN
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City | CELINA
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State | TX
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Zip | 75009-6364
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Country | US
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Telephone | 469-952-7197
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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 | 121850
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License Number State | TX
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