Provider Demographics
NPI:1366328445
Name:MAGNUS, SHERRY SELLE (AUD)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:SELLE
Last Name:MAGNUS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S. JUPITER RD.
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7108
Mailing Address - Country:US
Mailing Address - Phone:972-487-3300
Mailing Address - Fax:972-485-4921
Practice Address - Street 1:501 S. JUPITER RD.
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7108
Practice Address - Country:US
Practice Address - Phone:972-487-3300
Practice Address - Fax:972-485-4921
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50421231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist