Active NPI
Raegan Glentz
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1194615930
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 123915
- Practice address
- 2635 Prospect Ridge Dr Apt 9204
Fort Worth, TX 76110 - Phone
- (325) 218-2688
- NPI assigned
- Jul 3, 2025
- 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 | 123915 | TX | Primary |
Addresses
Primary practice location
2635 Prospect Ridge Dr Apt 9204
Fort Worth, TX 76110
Mailing address
2635 Prospect Ridge Dr Apt 9204
Fort Worth, TX 76110
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 |
|---|---|---|---|
| 123915 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751500800000",
"number": "1194615930",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2635 PROSPECT RIDGE DR APT 9204",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2635 PROSPECT RIDGE DR APT 9204",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "76110",
"telephone_number": "325-218-2688"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLENTZ",
"first_name": "RAEGAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-03",
"last_updated": "2025-07-03",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "123915",
"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 Jul 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.