Active NPI
Jessica Lo, SLP
- Speech-Language Pathologist
- Boerne, TX
National Provider Identifier
1053893552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 114892
- Practice address
- 7 Upper Balcones Rd
Boerne, TX 78006-8546 - Phone
- (210) 360-1662
- Fax
- (210) 568-2228
- NPI assigned
- Aug 30, 2018
- 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 | 114892 | TX | Primary |
Addresses
Primary practice location
7 Upper Balcones Rd
Boerne, TX 78006-8546
Mailing address
7 Upper Balcones Rd
Boerne, TX 78006-8546
Phone (210) 360-1662
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 |
|---|---|---|---|
| 114892 | TX | MD | Critical Care Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Kids Home Therapy Professional Limited Liability Company | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Home Health Agency
- Boerne, TX
- NPI 1790065845
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535587200000",
"number": "1053893552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 UPPER BALCONES RD",
"city": "BOERNE",
"state": "TX",
"postal_code": "780068546",
"telephone_number": "210-360-1662",
"fax_number": "210-568-2228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 UPPER BALCONES RD",
"city": "BOERNE",
"state": "TX",
"postal_code": "780068546",
"telephone_number": "210-360-1662",
"fax_number": "210-568-2228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LO",
"first_name": "JESSICA",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-30",
"last_updated": "2018-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "114892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boerne, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.