MEDICARE: FARRAH CADDELL

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	116515	TX

General Provider Information

NPI Number	:	1396385480
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARRAH CADDELL

Provider Business Mailing Address
First Line	:	8390 LYNDON B JOHNSON FWY STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1215
Country	:	US
Telephone Number	:	214-750-0042
Fax Number	:

Provider Business Practice Location Address
First Line	:	8390 LYNDON B JOHNSON FWY
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-1188
Country	:	US
Telephone Number	:	214-750-0042
Fax Number	:

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

Provider Enumeration Date	:	01/07/2020
Last Update Date	:	02/03/2026

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Directions to “ FARRAH CADDELL ” Practice Location

Language	Start Address	Practice Location

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