NPIMap

Organization Active NPI

Dream Therapy Center

  • Speech-Language Pathologist
  • Brownsville, TX
National Provider Identifier
1154793040
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104389 Issued in TX
Legal business name
DREAM THERAPY CENTER
Practice address
524 E Los Ebanos Blvd Ste B
Brownsville, TX 78520
Phone
(956) 572-1908
Fax
(888) 388-8379
NPI assigned
Oct 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Authorized official

Name
Mr. Joseph Modesto
Title
Administrator
Phone
(956) 572-1908

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 112112 TX
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X 104389 TX Primary
Physical Therapy Clinic/Center 261QP2000X 1158203 TX

Addresses

Primary practice location

524 E Los Ebanos Blvd Ste B
Brownsville, TX 78520

Mailing address

3402 Brasilia
Brownsville, TX 78526-1229
Phone (956) 572-1908

Other identifiers 3

IdentifierTypeStateIssuer
340582101MedicaidTX
205432203MedicaidTX
206658104MedicaidTX

National Provider Directory

National Provider Directory

Locations

524 E Los Ebanos Blvd
Ste B
Brownsville, TX 78520
Phone (956) 572-1908

Practitioners & affiliated clinicians

Practitioners 9

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": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531699200000",
    "number": "1154793040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3402 BRASILIA",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785261229",
            "telephone_number": "956-572-1908",
            "fax_number": "888-388-8379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 E LOS EBANOS BLVD STE B",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "78520",
            "telephone_number": "956-572-1908",
            "fax_number": "888-388-8379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAM THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2018-07-16",
        "status": "A",
        "authorized_official_last_name": "MODESTO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "956-572-1908",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112112",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104389",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1158203",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340582101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205432203",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206658104",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brownsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2018; 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.