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NPI Code Detail

MEDICARE: BAILEY MCDANIEL M.S. CCC-SLP

MEDICARE: BAILEY MCDANIEL 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 Pathologist122793TX

General Provider Information

NPI Number : 1740008432
Entity Type Code : Individual
Provider Name (Legal Business Name) : BAILEY MCDANIEL M.S. CCC-SLP
Provider Business Mailing Address
First Line : 3964 WATERCOURSE DR APT 1168
Second Line :
City : FORT WORTH
State : TX
Zip : 76109-2065
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7060 CAMP BOWIE BLVD
Second Line :
City : FORT WORTH
State : TX
Zip : 76116-7119
Country : US
Telephone Number : 806-570-8369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/01/2024
Last Update Date : 10/01/2024

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Directions to “ BAILEY MCDANIEL M.S. CCC-SLP” Practice Location

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