Provider Demographics
NPI:1225899404
Name:MCGUIRE, MADISON (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12880 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-1532
Mailing Address - Country:US
Mailing Address - Phone:972-387-1100
Mailing Address - Fax:
Practice Address - Street 1:12880 HILLCREST RD STE 102
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-1501
Practice Address - Country:US
Practice Address - Phone:972-387-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14457655235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist