Mary M. Augustine, M.S., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Coppell, TX
NPI 1629201983 · NPPES record last updated May 25, 2021
Key facts
- NPI
- 1629201983
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 103453 (TX)
- Practice address
- 580 S Denton Tap Rd Ste 270
Coppell, TX 75019-4094 - Phone
- (469) 763-9459
- NPI assigned
- Sep 2, 2009
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Tech University Health Sciences Center Lubbock | Past | Accepting new patients | |
| University of Texas at Dallas | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 103453 | TX | Yes |
Addresses
Primary practice location
580 S Denton Tap Rd Ste 270
Coppell, TX 75019-4094
Mailing address
413 Stonebridge Cir
Allen, TX 75013-3012
Phone (214) 991-2059
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All providers in Coppell, 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 May 25, 2021. 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.