Provider Demographics
NPI:1760634075
Name:MCGRAW, TARA (MS CCC)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:MCGRAW
Suffix:
Gender:F
Credentials:MS CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3716 OVILLA RD
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-5510
Mailing Address - Country:US
Mailing Address - Phone:469-883-6221
Mailing Address - Fax:
Practice Address - Street 1:3716 OVILLA RD
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-5510
Practice Address - Country:US
Practice Address - Phone:469-883-6221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AR203086235Z00000X
TX104776235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist