Individual provider Active NPI

Erika Gaytan

  • Speech-Language Assistant
  • San Juan, TX
National Provider Identifier
1114396140
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
34645 Issued in TX
Practice address
1205 N Raul Longoria Rd
Suite I
San Juan, TX 78589-3720
Phone
(956) 782-5800
Fax
(956) 782-5802
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 34645 TX Primary

Addresses

Primary practice location

1205 N Raul Longoria Rd
Suite I
San Juan, TX 78589-3720

Mailing address

1205 N Raul Longoria Rd
Suite I
San Juan, TX 78589-3720
Phone (956) 782-5800

Other identifiers 1

IdentifierTypeStateIssuer
34645OtherTXSTATE LICENSE

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

LicenseStateTypeSpecialty
34645TXMDDentist Anesthesiologist

NPI Registry JSON

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

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1114396140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 N RAUL LONGORIA RD",
            "address_2": "SUITE I",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893720",
            "telephone_number": "956-782-5800",
            "fax_number": "956-782-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 N RAUL LONGORIA RD",
            "address_2": "SUITE I",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893720",
            "telephone_number": "956-782-5800",
            "fax_number": "956-782-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYTAN",
        "first_name": "ERIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "34645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "34645",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.