Individual provider Active NPI

Audra Gail Soto, M.S.,CCC/SLP

  • Speech-Language Pathologist
  • Edinburg, TX
National Provider Identifier
1043455629
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
102914 Issued in TX
Practice address
3804 S Jackson Rd # 1
Edinburg, TX 78539-6681
Phone
(956) 296-3001
Fax
(956) 296-3000
NPI assigned
Dec 10, 2008
Last updated
Mar 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 102914 TX Primary

Addresses

Primary practice location

3804 S Jackson Rd # 1
Edinburg, TX 78539-6681

Mailing address

6002 Nacahuita LN
Harlingen, TX 78552-1908
Phone (956) 647-8762

Other practice location 1

615 Camelot Dr
Harlingen, TX 78550-8472
Phone (956) 296-2701

Other identifiers 3

IdentifierTypeStateIssuer
387283002MedicaidTX
H08LZ45701OtherTXBCBS
387283003MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
102914TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
RGV Mobile Dysphagia Diagnostics, PLLC Speech-Language Pathologist CurrentSince Sep 5, 2021 Accepting new patients
Noble Home Health Therapy LLC CurrentSince Sep 6, 2020 Accepting new patients
University of Texas Rio Grande Valley Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584576000000",
    "number": "1043455629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6002 NACAHUITA LN",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785521908",
            "telephone_number": "956-647-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3804 S JACKSON RD # 1",
            "city": "EDINBURG",
            "state": "TX",
            "postal_code": "785396681",
            "telephone_number": "956-296-3001",
            "fax_number": "956-296-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "615 Camelot Dr",
            "address_purpose": "LOCATION",
            "city": "Harlingen",
            "state": "TX",
            "postal_code": "785508472",
            "country_code": "US",
            "telephone_number": "956-296-2701",
            "fax_number": "956-296-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO",
        "first_name": "AUDRA",
        "middle_name": "GAIL",
        "name_prefix": "Mrs.",
        "credential": "M.S.,CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "102914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387283002",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "H08LZ45701",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "387283003",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edinburg, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.