NPIMap

Organization Active NPI

Montgomery Speech Therapy PLLC

  • Multi-Specialty Clinic/Center
  • Montgomery, TX
National Provider Identifier
1134603269
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MONTGOMERY SPEECH THERAPY PLLC
Practice address
21325 Eva St
Montgomery, TX 77356-1967
Phone
(832) 808-5942
Fax
(346) 202-0123
NPI assigned
Sep 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Kristin De Meo, MS CCC-SLPNPI 1346724895
Title
President
Phone
(936) 463-1788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

21325 Eva St
Montgomery, TX 77356-1967

Mailing address

21325 Eva St
Montgomery, TX 77356-1967
Phone (936) 463-1788

Other names 1

  • Play Pediatric Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260408001746 TX Part B Supplier - Clinic/Group Practice 5294200176 Receives reassigned benefits from 2 practitioners
Practice locations: Montgomery, TX

National Provider Directory

National Provider Directory

Locations

20821 Eva St
Ste H
Montgomery, TX 77356

21325 Eva St
Montgomery, TX 77356
Phone (832) 808-5942

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1134603269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21325 EVA ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773561967",
            "telephone_number": "936-463-1788",
            "fax_number": "346-202-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21325 EVA ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773561967",
            "telephone_number": "832-808-5942",
            "fax_number": "346-202-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY SPEECH THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-25",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "DE MEO",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-463-1788",
        "authorized_official_credential": "MS CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Play Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Play Pediatric Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montgomery, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.