MEDICARE: CECILIA CRUZ MACKAY M.A., 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
1	235Z00000X	Speech-Language Pathologist	19892	TX

General Provider Information

NPI Number	:	1811991425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CECILIA CRUZ MACKAY M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	15901 CENTRAL COMMERCE DR
Second Line	:	STE 301
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2044
Country	:	US
Telephone Number	:	512-251-7775
Fax Number	:	512-251-7776

Provider Business Practice Location Address
First Line	:	15901 CENTRAL COMMERCE DR
Second Line	:	STE 301
City	:	PFLUGERVILLE
State	:	TX
Zip	:	78660-2044
Country	:	US
Telephone Number	:	512-251-7775
Fax Number	:	512-251-7776

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	07/08/2007

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Directions to “ CECILIA CRUZ MACKAY M.A., CCC-SLP” Practice Location

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