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NPI Code Detail

MEDICARE: MAKAYLA JIMENEZ

MEDICARE: MAKAYLA JIMENEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant43041TX

General Provider Information

NPI Number : 1023976545
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAKAYLA JIMENEZ
Provider Business Mailing Address
First Line : 2609 FAIRMONT CIR
Second Line :
City : CORSICANA
State : TX
Zip : 75110-1808
Country : US
Telephone Number : 903-602-6432
Fax Number :
Provider Business Practice Location Address
First Line : 4201 SPRING VALLEY RD STE 600
Second Line :
City : DALLAS
State : TX
Zip : 75244-1209
Country : US
Telephone Number : 866-919-3240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2026
Last Update Date : 01/13/2026

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Directions to “ MAKAYLA JIMENEZ ” Practice Location

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