Marc Fagnan, M.A. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

101658 Issued in TX

Practice address

2535 Lone Star Drive
Dallas, TX 75212

Phone

(214) 467-9787

NPI assigned

May 4, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992917421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3664 PALLOS VERDAS DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75229",
            "telephone_number": "214-350-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 LONE STAR DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75212",
            "telephone_number": "214-467-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGNAN",
        "first_name": "MARC",
        "credential": "M.A. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "101658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Elise Fagan, PT
• Diane Fagelman Birk, M.D.
• Isa Faghihi
• Salmaan Faghihi
• Milad Faghihifar, D.C.
• Brian Keith Fahey, MD
• Travis Fahey, D.C.
• Anfal Fahim, M.D.
• Kiana Fahimipour, MD
• Wendy Fahle, PT

• Speech-Language Pathologist in Dallas, TX
• Providers in Dallas, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.