Provider Demographics
NPI:1548983679
Name:SCOTT, PHYLLIS R (PH D)
Entity type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:R
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7425 WESTGREEN BLVD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-0188
Mailing Address - Country:US
Mailing Address - Phone:346-227-6000
Mailing Address - Fax:
Practice Address - Street 1:7425 WESTGREEN BLVD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-0188
Practice Address - Country:US
Practice Address - Phone:346-227-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist