MEDICARE: PAULA DARCANGELO MS, CCC-SLP

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	19795	TX

General Provider Information

NPI Number	:	1447995196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAULA DARCANGELO MS, CCC-SLP

Provider Business Mailing Address
First Line	:	1535 SARA LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4185
Country	:	US
Telephone Number	:	281-853-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	1535 SARA LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4185
Country	:	US
Telephone Number	:	281-853-4101
Fax Number	:

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

Provider Enumeration Date	:	04/27/2022
Last Update Date	:	04/27/2022

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