Provider Demographics
NPI:1538784673
Name:VIGERS, TAWAINE L (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TAWAINE
Middle Name:L
Last Name:VIGERS
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 1:19519 MONTCLAIR MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4128
Mailing Address - Country:US
Mailing Address - Phone:832-524-8720
Mailing Address - Fax:
Practice Address - Street 1:2101 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6108
Practice Address - Country:US
Practice Address - Phone:281-599-5540
Practice Address - Fax:281-550-5541
Is Sole Proprietor?:No
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist