Provider Demographics
NPI:1245771245
Name:FROST, MORGAN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:GARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1306 COUNTY ROAD 3317
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:TX
Mailing Address - Zip Code:75571-5398
Mailing Address - Country:US
Mailing Address - Phone:903-767-0819
Mailing Address - Fax:
Practice Address - Street 1:507 E W M WATSON BLVD
Practice Address - Street 2:
Practice Address - City:DAINGERFIELD
Practice Address - State:TX
Practice Address - Zip Code:75638
Practice Address - Country:US
Practice Address - Phone:903-645-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2019-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113986235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist