IndividualActive
Samout Kettavong, CCC-SLP
NPI 1962982017 · Speech-Language Pathologist · Dallas, TX
Provider details
- NPI number
- 1962982017
- Entity type
- Individual
- Primary specialty
- Speech-Language PathologistSpeech, Language and Hearing Service Providers
- Credential
- CCC-SLP
- Sex
- Female
- Sole proprietor
- No
- License
- 114529 (TX)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3230 Remond Dr
Dallas, TX 75211-1619
Phone: (214) 743-1200
Street-level locationGet directions
Mailing address
1881 Sylvan Ave Ste 150
Dallas, TX 75208-2002
Additional practice locations (2)
- 1881 Sylvan Ave Ste 150Dallas, TX 75208-2002Phone: (214) 743-1200
- 1881 Sylvan Ave Ste 100Dallas, TX 75208-2030Phone: (214) 333-7041
Registry dates
- Enumerated
- 2018-08-17
- Last updated
- 2026-05-11
- Certified
- 2026-05-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.