KLC Pediatric Therapy, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

KLC PEDIATRIC THERAPY, LLC

Practice address

1015 Champions Dr # 102
Aledo, TX 76008-3206

Phone

(214) 803-1699

NPI assigned

Aug 16, 2023

Organization subpart

No

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

Authorized official

Name

Jacey Bullock, M.S., CCC-SLPNPI 1568717155

Title

Owner

Phone

(214) 803-1699

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacey Layne Bullock, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Aledo, TX
  • NPI 1568717155
  NPD Authorized official
• Bailey Anne Travis, CCC-SLP

  • Speech-Language Pathologist
  • Aledo, TX
  • NPI 1619634201
  NPD

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692230400000",
    "number": "1306629142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 PRAIRIE RUN",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760081170",
            "telephone_number": "214-803-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 CHAMPIONS DR # 102",
            "city": "ALEDO",
            "state": "TX",
            "postal_code": "760083206",
            "telephone_number": "214-803-1699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Highway 352",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751496897",
            "country_code": "US",
            "telephone_number": "214-803-1699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KLC PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-16",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A",
        "authorized_official_last_name": "BULLOCK",
        "authorized_official_first_name": "JACEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-803-1699",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sydney Kamin, MS, LAT, ATC
• Priscilla Keller, IBCLC
• Kelly Robinson Kemp, D.D.S.
• Suhail Khan, M.D.
• Ashley Morgan Kirkland
• Sandy Koneiber
• Kreich Consulting, LLC
• Shaun H Kretzschmar, DO
• Kris Daniel Porter, MD, PA
• Rylie Michelle Kubes, D.C.

• Speech-Language Pathologist in Aledo, TX
• Providers in Aledo, 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 Aug 17, 2023; 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.