Provider Demographics
NPI:1194141960
Name:SHULL, MEGAN L (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:L
Last Name:SHULL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6735
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5119
Mailing Address - Country:US
Mailing Address - Phone:214-755-7504
Mailing Address - Fax:214-975-1012
Practice Address - Street 1:2160 FOX RIDGE TRL
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-2605
Practice Address - Country:US
Practice Address - Phone:214-755-7504
Practice Address - Fax:214-975-1012
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2019-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist