Individual provider Active NPI

Veronica De la Cruz, MS CCC SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1194035402
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104202 Issued in TX
Practice address
5601 Bridge St
Suite 490
Fort Worth, TX 76112-2384
Phone
(817) 446-5000
NPI assigned
Oct 20, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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 104202 TX Primary

Addresses

Primary practice location

5601 Bridge St
Suite 490
Fort Worth, TX 76112-2384

Mailing address

853 Globe Ave
Blue Mound, TX 76131-1540
Phone (817) 437-7622

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
104202TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1194035402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 GLOBE AVE",
            "city": "BLUE MOUND",
            "state": "TX",
            "postal_code": "761311540",
            "telephone_number": "817-437-7622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 BRIDGE ST",
            "address_2": "SUITE 490",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761122384",
            "telephone_number": "817-446-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA CRUZ",
        "first_name": "VERONICA",
        "name_prefix": "Miss",
        "credential": "MS CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.