Brazos Valley Speech Therapy, PLLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

BRAZOS VALLEY SPEECH THERAPY, PLLC

Practice address

1645 Greens Prairie Rd W Ste 401a
College Station, TX 77845-8414

Phone

(979) 429-3754

NPI assigned

Jan 7, 2022

Last updated

Jun 27, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bethany Neisch, CCC-SLPNPI 1659042471

Title

Owner

Phone

(979) 429-3754

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Bethany Neisch, CCC-SLP

  • Speech-Language Pathologist
  • College Station, TX
  • NPI 1659042471
  NPD Authorized official

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1265193692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9304 WESLAYAN CT",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458790",
            "telephone_number": "979-429-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 GREENS PRAIRIE RD W STE 401A",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778458414",
            "telephone_number": "979-429-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VALLEY SPEECH THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "NEISCH",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-429-3754",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in College Station, TX
• Providers in College Station, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.