Provider Demographics
NPI:1346526118
Name:REYES, MEGAN NICOLE (MS, SLP-CF)
Entity Type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:NICOLE
Last Name:REYES
Suffix:
Gender:F
Credentials:MS, SLP-CF
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Other - Middle Name:
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Mailing Address - Street 1:1001 LOUISIANA AVE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2833
Mailing Address - Country:US
Mailing Address - Phone:361-853-0488
Mailing Address - Fax:361-853-0489
Practice Address - Street 1:1001 LOUISIANA AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2833
Practice Address - Country:US
Practice Address - Phone:361-853-0488
Practice Address - Fax:361-853-0489
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2024-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX107007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742629082Medicaid