Individual provider Active NPI

Berenice Huijon-Servin

  • Speech-Language Assistant
  • Dallas, TX
National Provider Identifier
1255005690
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
41847 Issued in TX
Practice address
14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856
Phone
(866) 919-3240
NPI assigned
Aug 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 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 Assistant 2355S0801X 41847 TX Primary

Addresses

Primary practice location

14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856

Mailing address

14651 Dallas Pkwy Ste 200
Dallas, TX 75254-8856
Phone (866) 919-3240

Other practice location 1

2300 Pecan St
Bastrop, TX 78602-1540
Phone (512) 909-5517

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
41847TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1628380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1255005690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14651 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548856",
            "telephone_number": "866-919-3240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14651 DALLAS PKWY STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752548856",
            "telephone_number": "866-919-3240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Pecan St",
            "address_purpose": "LOCATION",
            "city": "Bastrop",
            "state": "TX",
            "postal_code": "786021540",
            "country_code": "US",
            "telephone_number": "512-909-5517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUIJON-SERVIN",
        "first_name": "BERENICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "41847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.