Active NPI
Janice Dudley, SPEECH THER.
- Speech-Language Pathologist
- Bryan, TX
National Provider Identifier
1164549853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 175179
- Practice address
- 1111 Edgewood Dr
Bryan, TX 77802-3720 - Phone
- (979) 846-1951
- NPI assigned
- Mar 26, 2007
- 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 | 175179 | TX | Primary |
Addresses
Primary practice location
1111 Edgewood Dr
Bryan, TX 77802-3720
Mailing address
1111 Edgewood Dr
Bryan, TX 77802-3720
Phone (979) 846-1951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175179 | Other | TX | SPEECH LICENSE NUMBER |
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 |
|---|---|---|---|
| 175179 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250640000000",
"number": "1164549853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 EDGEWOOD DR",
"city": "BRYAN",
"state": "TX",
"postal_code": "778023720",
"telephone_number": "979-846-1951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 EDGEWOOD DR",
"city": "BRYAN",
"state": "TX",
"postal_code": "778023720",
"telephone_number": "979-846-1951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDLEY",
"first_name": "JANICE",
"credential": "SPEECH THER.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2009-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "175179",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LICENSE NUMBER",
"identifier": "175179",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.