Provider Demographics
NPI:1982094454
Name:FERGUSON, SABRA SUSANNE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SABRA
Middle Name:SUSANNE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MRS
Other - First Name:SABRA
Other - Middle Name:SUSANNE
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
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:817-789-6849
Practice Address - Street 1:2700 EARL RUDDER FWY S # 1200
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5010
Practice Address - Country:US
Practice Address - Phone:979-307-5850
Practice Address - Fax:979-307-5858
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist