MEDICARE: FLOWER MOUND SPEECH THERAPY PLLC

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1477289809
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOWER MOUND SPEECH THERAPY PLLC

Provider Business Mailing Address
First Line	:	2221 JUSTIN RD STE 119-118
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-4848
Country	:	US
Telephone Number	:	214-444-9627
Fax Number	:

Provider Business Practice Location Address
First Line	:	2221 JUSTIN RD STE 119-118
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-4848
Country	:	US
Telephone Number	:	214-444-9627
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ERICA BROWN
Credential	:	MS, CCC/SLP
Telephone Number	:	214-444-9627

Provider Enumeration Date	:	07/27/2022
Last Update Date	:	01/13/2023

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