NPIMap

Organization Active NPI

Education Service Center

  • Speech-Language Pathologist
  • San Angelo, TX
National Provider Identifier
1245548452
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104463 Issued in TX
Legal business name
EDUCATION SERVICE CENTER
Practice address
612 S Irene St
San Angelo, TX 76903-6629
Phone
(325) 658-3271
Fax
(325) 653-0036
NPI assigned
Sep 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Ms. Norma Bradley
Title
Billing Specialist
Phone
(325) 658-6571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 104463 TX Primary

Addresses

Primary practice location

612 S Irene St
San Angelo, TX 76903-6629

Mailing address

612 S Irene St
San Angelo, TX 76903-6629
Phone (325) 658-3271

Other identifiers 1

IdentifierTypeStateIssuer
1396867966MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Education Service Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1245548452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 S IRENE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036629",
            "telephone_number": "325-658-3271",
            "fax_number": "325-653-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 S IRENE ST",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769036629",
            "telephone_number": "325-658-3271",
            "fax_number": "325-653-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUCATION SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "NORMA",
        "authorized_official_title_or_position": "BILLING SPECIALIST",
        "authorized_official_telephone_number": "325-658-6571",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396867966",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.