MEDICARE: EMILY WEBER

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
1	235Z00000X	Speech-Language Pathologist	116546	TX

General Provider Information

NPI Number	:	1093388472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY WEBER

Provider Business Mailing Address
First Line	:	2810 ROUTH CREEK PKWY APT 3221
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-0124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7217 TELECOM PKWY
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2202
Country	:	US
Telephone Number	:	469-800-2100
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2021
Last Update Date	:	07/22/2021

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Directions to “ EMILY WEBER ” Practice Location

Language	Start Address	Practice Location

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