Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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MS. Kellie Natasha Wilson, MEDCCC-SLP

Individual provider Speech-Language Pathologist · NPI 1083886816

MS. Kellie Natasha Wilson, MEDCCC-SLP is a Qualified Speech Language Pathologist in Sugar Land, Texas. Qualified in 2004, 22 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
22
Licensed in
TX
In the registry since
2008
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Practice location Address checks out

15015 W Airport Blvd Apt 612
Sugar Land, TX 77478-7087
Phone: (281) 242-5913
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X · Licence 102896 (TX)

Record details

NPI number1083886816
Entity typeIndividual (Type 1)
GenderFemale
Credentials MEDCCC-SLP
Sole proprietorYes
NPI enumeratedApril 1, 2008
Last updated in NPPESApril 1, 2008

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyQUALIFIED SPEECH LANGUAGE PATHOLOGIST
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Sugar Land