Provider Demographics
NPI:1265314850
Name:MOUSER, CLACIE BRIANNE
Entity type:Individual
Prefix:
First Name:CLACIE
Middle Name:BRIANNE
Last Name:MOUSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLACIE
Other - Middle Name:BRIANNE
Other - Last Name:TERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2005 CHAPEL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-8881
Mailing Address - Country:US
Mailing Address - Phone:469-475-0116
Mailing Address - Fax:
Practice Address - Street 1:2011 BROADWAY ST STE 130
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5945
Practice Address - Country:US
Practice Address - Phone:281-997-8509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122760235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist