MEDICARE: RESIDUAL HEALTH

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	:	1700695574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESIDUAL HEALTH

Provider Business Mailing Address
First Line	:	1140 W PIONEER PKWY STE D
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6383
Country	:	US
Telephone Number	:	682-323-7661
Fax Number	:	817-549-4403

Provider Business Practice Location Address
First Line	:	1140 W PIONEER PKWY STE D
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6383
Country	:	US
Telephone Number	:	682-323-7661
Fax Number	:	817-549-4403

Authorized Official
Title or Position	:	CEO
Name	:	RENADJA TAYLOR
Credential	:	RD
Telephone Number	:	682-323-7661

Provider Enumeration Date	:	01/06/2025
Last Update Date	:	04/20/2026

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1629564117 — MS. SIMONE A TUNSTALL MS, CCC-SLP
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Directions to “RESIDUAL HEALTH ” Practice Location

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