Provider Demographics
NPI:1588046130
Name:SUMRELL, MARGARET (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SUMRELL
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 1:305 NE LOOP 820
Mailing Address - Street 2:BUSINESS TOWER 1 SUITE 200
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76053-7209
Mailing Address - Country:US
Mailing Address - Phone:817-292-8787
Mailing Address - Fax:817-769-6849
Practice Address - Street 1:1349 EMPIRE CENTRAL DR
Practice Address - Street 2:SUITE 516
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4066
Practice Address - Country:US
Practice Address - Phone:469-364-8680
Practice Address - Fax:855-275-2406
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106273235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist