NPIMap

Organization Active NPI

Brazosport Speech Pathology Services, PLLC

  • Speech-Language Pathologist
  • Lake Jackson, TX
National Provider Identifier
1255357414
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
16308 Issued in TX
Legal business name
BRAZOSPORT SPEECH PATHOLOGY SERVICES, PLLC
Practice address
460 Plantation Drive
Lake Jackson, TX 77566
Phone
(979) 480-0333
Fax
(979) 480-0316
NPI assigned
Jul 14, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Julie Danette Holt, MS, CCC-SLP
Title
Owner
Phone
(979) 480-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 16308 TX Primary

Addresses

Primary practice location

460 Plantation Drive
Lake Jackson, TX 77566

Mailing address

460 Plantation Drive
Lake Jackson, TX 77566
Phone (979) 480-0333

National Provider Directory

National Provider Directory

Locations

460 Plantation Dr
Lake Jackson, TX 77566
Phone (979) 480-0333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255357414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 PLANTATION DRIVE",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-480-0333",
            "fax_number": "979-480-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 PLANTATION DRIVE",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-480-0333",
            "fax_number": "979-480-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOSPORT SPEECH PATHOLOGY SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "DANETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-480-0333",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "16308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.