Individual provider Active NPI

Macey Flack, SLP

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1164174074
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
114961 Issued in TX
Practice address
3000 Weslayan St Ste 105
Houston, TX 77027-5701
Phone
(713) 218-9947
Fax
(713) 218-8988
NPI assigned
Jan 21, 2022
Last updated
Jan 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 114961 TX Primary

Addresses

Primary practice location

3000 Weslayan St Ste 105
Houston, TX 77027-5701

Mailing address

1025 Herkimer St
Houston, TX 77008-6743
Phone (713) 659-2803

Other names 1

  • Macey Wolfe Former name

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
114961TXMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1642723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1164174074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 HERKIMER ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770086743",
            "telephone_number": "713-659-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 WESLAYAN ST STE 105",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770275701",
            "telephone_number": "713-218-9947",
            "fax_number": "713-218-8988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "MACEY",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-21",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACEY",
            "last_name": "WOLFE",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.