Individual provider Active NPI

Mark M Moke, SLPA

  • Speech-Language Assistant
  • Laredo, TX
National Provider Identifier
1306041025
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
34024 Issued in TX
Practice address
2335 E Saunders St
Suite 2
Laredo, TX 78041-5434
Phone
(956) 791-4800
Fax
(956) 791-4422
NPI assigned
Jun 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 34024 TX Primary

Addresses

Primary practice location

2335 E Saunders St
Suite 2
Laredo, TX 78041-5434

Mailing address

2335 E Saunders St
Suite 2
Laredo, TX 78041-5434
Phone (956) 791-4800

Other identifiers 1

IdentifierTypeStateIssuer
34024OtherTXSTATE LICENSE

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
34024TXMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306041025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2335 E SAUNDERS ST",
            "address_2": "SUITE 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415434",
            "telephone_number": "956-791-4800",
            "fax_number": "956-791-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 E SAUNDERS ST",
            "address_2": "SUITE 2",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780415434",
            "telephone_number": "956-791-4800",
            "fax_number": "956-791-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKE",
        "first_name": "MARK",
        "middle_name": "M",
        "credential": "SLPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "34024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "34024",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.