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NPI Code Detail

MEDICARE: KARA MICHELE FILLOON

MEDICARE: KARA MICHELE FILLOON
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 Pathologist114217TX

General Provider Information

NPI Number : 1700605532
Entity Type Code : Individual
Provider Name (Legal Business Name) : KARA MICHELE FILLOON
Provider Business Mailing Address
First Line : 4404 OWENDALE DR
Second Line :
City : BENBROOK
State : TX
Zip : 76116-1428
Country : US
Telephone Number : 903-235-8754
Fax Number :
Provider Business Practice Location Address
First Line : 4109 WESTRIDGE AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7403
Country : US
Telephone Number : 817-813-9431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2024
Last Update Date : 10/08/2024

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Directions to “ KARA MICHELE FILLOON ” Practice Location

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