Active NPI
Mario Campos
- Speech-Language Pathologist
- Mission, TX
National Provider Identifier
1053898734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 34638
- Practice address
- 409 N Bryan Rd Ste 106
Mission, TX 78572-6293 - Phone
- (956) 600-7137
- Fax
- (956) 600-7139
- NPI assigned
- Jul 25, 2018
- Sex
- Male
- 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 | 34638 | TX | Primary |
Addresses
Primary practice location
409 N Bryan Rd Ste 106
Mission, TX 78572-6293
Mailing address
409 N Bryan Rd Ste 106
Mission, TX 78572-6293
Phone (956) 600-7137
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 |
|---|---|---|---|
| 34638 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532476800000",
"number": "1053898734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 N BRYAN RD STE 106",
"city": "MISSION",
"state": "TX",
"postal_code": "785726293",
"telephone_number": "956-600-7137",
"fax_number": "956-600-7139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 N BRYAN RD STE 106",
"city": "MISSION",
"state": "TX",
"postal_code": "785726293",
"telephone_number": "956-600-7137",
"fax_number": "956-600-7139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPOS",
"first_name": "MARIO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-25",
"last_updated": "2018-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "34638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.