Active NPI
Lisa L Hendricks
- Speech-Language Pathologist
- League City, TX
National Provider Identifier
1114606241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 12279
- Practice address
- 2425 E Main St
League City, TX 77573-2743 - Phone
- (281) 284-0000
- NPI assigned
- Jul 17, 2023
- 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 | 12279 | TX | Primary |
Addresses
Primary practice location
2425 E Main St
League City, TX 77573-2743
Mailing address
738 Richvale LN
Houston, TX 77062-4223
Phone (281) 686-2400
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 |
|---|---|---|---|
| 12279 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1114606241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "738 RICHVALE LN",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770624223",
"telephone_number": "281-686-2400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 E MAIN ST",
"city": "LEAGUE CITY",
"state": "TX",
"postal_code": "775732743",
"telephone_number": "281-284-0000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENDRICKS",
"first_name": "LISA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-17",
"last_updated": "2023-07-17",
"certification_date": "2023-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "12279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in League City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.