Individual provider Active NPI

Amanda Lizbeth Sifuentes

  • Speech-Language Pathologist
  • Pearland, TX
National Provider Identifier
1194255174
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
120242 Issued in TX
Practice address
9330 Broadway St Ste 312
Pearland, TX 77584-7895
Phone
(713) 383-9700
NPI assigned
Jun 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 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 120242 TX Primary

Addresses

Primary practice location

9330 Broadway St Ste 312
Pearland, TX 77584-7895

Mailing address

9220 Kirby Dr Ste 1000
Houston, TX 77054-2534
Phone (713) 383-9700

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
120242TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1194255174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9220 KIRBY DR STE 1000",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542534",
            "telephone_number": "713-383-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 BROADWAY ST STE 312",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847895",
            "telephone_number": "713-383-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIFUENTES",
        "first_name": "AMANDA",
        "middle_name": "LIZBETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-13",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "120242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.