Provider Demographics
NPI:1992721476
Name:NOURY, NANCY J (MS, CC-SLP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:NOURY
Suffix:
Gender:F
Credentials:MS, CC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LONGMIRE RD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1893
Mailing Address - Country:US
Mailing Address - Phone:936-363-4071
Mailing Address - Fax:
Practice Address - Street 1:750 LONGMIRE RD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1893
Practice Address - Country:US
Practice Address - Phone:936-363-4071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00793235Z00000X
TX108759235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI2092OtherEI NHPRC
RI292177OtherEI BLUE CROSS
RI4600103OtherEI UHP
RIES01788Medicaid
RI412296OtherEI BLUE CHIP