Individual provider Active NPI

Daphne Kolstoe, M.S

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1104702364
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
122624 Issued in TX
Practice address
Waverly Park Elementary School
3604 Cimmaron Trail
Fort Worth, TX 76116
Phone
(817) 815-6700
NPI assigned
Aug 13, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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 122624 TX Primary

Addresses

Primary practice location

Waverly Park Elementary School
3604 Cimmaron Trail
Fort Worth, TX 76116

Mailing address

736 Dalrock Rd
Fort Worth, TX 76131-3519
Phone (612) 258-8928

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
122624TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1104702364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "736 DALROCK RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761313519",
            "telephone_number": "612-258-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WAVERLY PARK ELEMENTARY SCHOOL",
            "address_2": "3604 CIMMARON TRAIL",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76116",
            "telephone_number": "817-815-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLSTOE",
        "first_name": "DAPHNE",
        "credential": "M.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "122624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.