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NPI Code Detail

MEDICARE: TAYLOR D PACK M.S., CCC-SLP

MEDICARE: TAYLOR D PACK M.S., 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
1235Z00000XSpeech-Language Pathologist118277TX

General Provider Information

NPI Number : 1588129845
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR D PACK M.S., CCC-SLP
Provider Business Mailing Address
First Line : 2520 WW THORNE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77073-3406
Country : US
Telephone Number : 281-449-1011
Fax Number : --
Provider Business Practice Location Address
First Line : 2520 WW THORNE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77073-3406
Country : US
Telephone Number : 281-449-1011
Fax Number : --
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2019
Last Update Date : 01/29/2026

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Directions to “ TAYLOR D PACK M.S., CCC-SLP” Practice Location

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