Piney Woods Speech Pathology, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PINEY WOODS SPEECH PATHOLOGY, PLLC

Practice address

526 S Wheeler St
Jasper, TX 75951-4540

Phone

(409) 202-5002

Fax

(844) 848-9342

NPI assigned

Apr 21, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stephanie Despain, MS, CCC/SLP

Title

Owner, Sole MBR

Phone

(409) 202-5002

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1033644596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 S WHEELER ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514540",
            "telephone_number": "409-202-5002",
            "fax_number": "844-848-9342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 S WHEELER ST",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759514540",
            "telephone_number": "409-202-5002",
            "fax_number": "844-848-9342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEY WOODS SPEECH PATHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "DESPAIN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER, SOLE MBR",
        "authorized_official_telephone_number": "409-202-5002",
        "authorized_official_credential": "MS, CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.