Individual provider Active NPI

Diana Nicole Perez

  • Speech-Language Pathologist
  • Boerne, TX
National Provider Identifier
1336084128
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
123728 Issued in TX
Practice address
18 Scenic Loop Rd # 200D
Boerne, TX 78006-8672
Phone
(830) 755-0098
Fax
(830) 327-0099
NPI assigned
Apr 20, 2026
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

18 Scenic Loop Rd
200D
Boerne, TX 78006-8606

3838 Lockhill Selma Rd
Apt 313
San Antonio, TX 78230-1570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260515003101 TX Practitioner - Qualified Speech Language Pathologist 3971072216 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123728TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bluebonnet Pediatric Therapy LLC CurrentSince Feb 6, 2022 Accepting new patients

Locations

18 Scenic Loop Rd
#200D
Boerne, TX 78006
Phone (817) 800-4431

18 Scenic Loop Rd
Ste 200D
Boerne, TX 78006
Phone (830) 755-0098

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 123728 TX Primary

Addresses

NPPES NPI Registry

Primary practice location

18 Scenic Loop Rd # 200D
Boerne, TX 78006-8672

Mailing address

3838 Lockhill Selma Rd Apt 313
San Antonio, TX 78230-1570
Phone (830) 755-0098

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 20, 2026.

{
    "created_epoch": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1336084128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 LOCKHILL SELMA RD APT 313",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782301570",
            "telephone_number": "830-755-0098",
            "fax_number": "830-327-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SCENIC LOOP RD # 200D",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068672",
            "telephone_number": "830-755-0098",
            "fax_number": "830-327-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "DIANA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "123728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.