| Angela Waggener, MS CCC-SLP | |
|
101 Watermere Dr, Southlake, TX 76092-8116 | |
| (817) 431-8668 | |
| Not Available |
| Full Name | Angela Waggener |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 101 Watermere Dr, Southlake, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760849830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 106854 (Texas) | Primary |
| Provider Name | Healthpro Heritage Rehab & Fitness Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1952531154 PECOS PAC ID: 6507832573 Enrollment ID: O20160330000839 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Waggener, MS CCC-SLP 5021 Marineway Dr, Fort Worth, TX 76135-1809 Ph: (405) 555-5555 | Angela Waggener, MS CCC-SLP 101 Watermere Dr, Southlake, TX 76092-8116 Ph: (817) 431-8668 |
Cathleen Shannon Hamby, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 101 Watermere Dr, Southlake, TX 76092 Phone: 817-524-0872 | |
Tatum Makenzie Hubbard, CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2425 E Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 817-442-0222 Fax: 817-442-0223 | |
Mrs. Evin Leann Fahey, M.S.CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 101 Watermere Dr, Southlake, TX 76092 Phone: 817-431-8668 Fax: 817-337-7622 | |
Lara Gabrielle Ely, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2400 N Carroll Ave, Southlake, TX 76092 Phone: 817-949-8400 | |
Calye Anderson, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 201 Watermere Dr, Southlake, TX 76092 Phone: 817-480-8085 | |
Monica Kaye Ortlieb Smothers, M.A., CCC-SLP Speech-Language Pathologist Medicare: Accepting Medicare Assignments Practice Location: 101 Watermere Dr, Southlake, TX 76092 Phone: 817-431-8668 Fax: 817-337-7622 | |
Grace Suzanne Gerbing, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1140 N Kimball Ave, Southlake, TX 76092 Phone: 817-479-7019 |