Active NPI
Amanda Tull
- Speech-Language Pathologist
- Mesquite, TX
National Provider Identifier
1053078451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 100899
- Practice address
- 714 E Kimbrough St
Mesquite, TX 75149-4420 - Phone
- (214) 497-1486
- NPI assigned
- Nov 19, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 100899 | TX | Primary |
Addresses
Primary practice location
714 E Kimbrough St
Mesquite, TX 75149-4420
Mailing address
2548 Brook Hollow CT
Mesquite, TX 75150-1221
Phone (214) 497-1486
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100899 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637280000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637280000000",
"number": "1053078451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2548 BROOK HOLLOW CT",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751501221",
"telephone_number": "214-497-1486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 E KIMBROUGH ST",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751494420",
"telephone_number": "214-497-1486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TULL",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-19",
"last_updated": "2021-11-19",
"certification_date": "2021-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "100899",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.