Kacie Evans
Individual provider Active NPI Speech-Language Pathologist · Lorena, TX
NPI 1033767140 · NPPES record last updated Oct 17, 2022
Key facts
- NPI
- 1033767140
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 113509 (TX)
- Practice address
- 1191 Old Lorena Rd
Lorena, TX 76655-3176 - Phone
- (817) 914-6670
- NPI assigned
- Sep 1, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113509 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 113509 | TX | Yes |
Addresses
Primary practice location
1191 Old Lorena Rd
Lorena, TX 76655-3176
Mailing address
1107 Purdue Dr
Arlington, TX 76012-5346
Phone (817) 914-6670
Other practice location 1
3933 Vista Greens Dr
Fort Worth, TX 76244-8165
Phone (817) 914-6670
Other practice location 2
630 Stoneglen Dr Ste B
Keller, TX 76248-3626
Phone (817) 914-6670
Other providers in Lorena, TX
- Bruner Health & Wellness, PLLC
- Noe Josue Chaparro
- Kristin J Craig
- Cross Creek Dental
- McKenna Endsley
- Tiffany Glenn
- Jesse Clark Griffin III
- James Matthew Horn
- James David Huffman
- Caroline Grace Jarvis
All providers in Lorena, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.