Shannon Lewis Servance, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

16446 Issued in TX

Practice address

3154 Bonney Briar Dr
Missouri City, TX 77459-3113

Phone

(281) 438-9973

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shannon L Servance Speech Therapy

  • Speech-Language Pathologist
  • Missouri City, TX
  • NPI 1679378798
  NPD Authorized official
• Apples and Bananas Pediatric Oral Motor and Dysphagia Center

  • Speech-Language Pathologist
  • Missouri City, TX
  • NPI 1649470030
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1376662064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3154 BONNEY BRIAR DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593113",
            "telephone_number": "281-438-9973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3154 BONNEY BRIAR DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774593113",
            "telephone_number": "281-438-9973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERVANCE",
        "first_name": "SHANNON",
        "middle_name": "LEWIS",
        "name_prefix": "Mrs.",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "16446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.