Provider Demographics
NPI:1932241858
Name:SPEECHCARE,INC.
Entity Type:Organization
Organization Name:SPEECHCARE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:SUSAN
Authorized Official - Last Name:LEGROW
Authorized Official - Suffix:
Authorized Official - Credentials:MACCC
Authorized Official - Phone:972-934-2807
Mailing Address - Street 1:14911 QUORUM DR
Mailing Address - Street 2:STE. 150
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7012
Mailing Address - Country:US
Mailing Address - Phone:972-934-2807
Mailing Address - Fax:
Practice Address - Street 1:14911 QUORUM DR
Practice Address - Street 2:STE. 150
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7012
Practice Address - Country:US
Practice Address - Phone:972-934-2807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11290235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120089101Medicaid
TX120089104Medicaid
TX120089102Medicaid
TX120089103Medicaid