Paula Nall – Speech-Language Pathologist

Key facts

NPI: 1154536662
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 16247 (TX)
Practice address: 7545 Bosque Blvd
Waco, TX 76712-3713
Phone: (254) 235-1850
NPI assigned: May 10, 2007
Sex: Female
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Theradat, LLC Hearing and Speech Clinic/Center · Waco, TX · NPI 1801009733

NPD (past) Authorized official

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
16247	TX	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Theradat, LLC		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	16247	TX	Yes

Addresses

Primary practice location

7545 Bosque Blvd
Waco, TX 76712-3713

Mailing address

7545 Bosque Blvd
Waco, TX 76712-3713
Phone (254) 235-1850

Other identifiers

Identifier	Type	State	Issuer
162082501	Medicaid	TX

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 13, 2008.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218585600000",
    "number": "1154536662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7545 BOSQUE BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123713",
            "telephone_number": "254-235-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7545 BOSQUE BLVD",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767123713",
            "telephone_number": "254-235-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALL",
        "first_name": "PAULA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "16247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162082501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

All providers in Waco, TX · Speech-Language Pathologist in Texas

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2008. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.