MEDICARE: KENDALL CHOCHOLEK

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

General Provider Information

NPI Number	:	1457286866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDALL CHOCHOLEK

Provider Business Mailing Address
First Line	:	2001 RANDOL MILL AVE
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-3438
Country	:	US
Telephone Number	:	760-562-8285
Fax Number	:

Provider Business Practice Location Address
First Line	:	1727 KELLER PKWY STE 19
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-3705
Country	:	US
Telephone Number	:	817-500-5895
Fax Number	:

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

Provider Enumeration Date	:	06/16/2026
Last Update Date	:	06/16/2026

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Directions to “ KENDALL CHOCHOLEK ” Practice Location

Language	Start Address	Practice Location

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