Robert Derrick Douglas, ST

Speech-Language Pathologist · Nacogdoches, TX

Individual Active NPI

NPI number 1104442508

Practice location

421 N Fredonia St
Nacogdoches, TX 75961-5010
Phone
(936) 569-3150

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NPI record

NPI
1104442508
Entity type
Individual (Type 1)
Enumeration date
June 22, 2020
Last updated
February 11, 2025
Certified
February 11, 2025
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Speech-Language Pathologist Primary 235Z00000X 112439 TX

Mailing address

4632 NE Stallings Dr
Nacogdoches, TX 75965-1620
Phone
(936) 569-3150

About Robert Douglas

Robert Derrick Douglas, ST is a healthcare provider registered in the NPI registry with the primary taxonomy Speech-Language Pathologist (code 235Z00000X). The practice location is 421 N Fredonia St, Nacogdoches, TX 75961-5010. The NPI number 1104442508 was assigned on June 22, 2020 and the record was last updated on February 11, 2025.

Robert Douglas lists a license in the registry: #112439 (TX) for Speech-Language Pathologist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Robert Derrick Douglas, ST?

The NPI number is 1104442508.

What is the phone number of Robert Douglas?

The phone number listed for the practice location is (936) 569-3150.

Where is Robert Douglas located?

421 N Fredonia St, Nacogdoches, TX 75961-5010.

What is the taxonomy code for Robert Douglas?

The primary taxonomy code is 235Z00000X – Speech-Language Pathologist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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