Active NPI
Susan De la Cruz, MS CCC-SLP
- Speech-Language Pathologist
- Euless, TX
National Provider Identifier
1336406776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109943
- Practice address
- 2192 Raines CT
Euless, TX 76039-4259 - Phone
- (787) 479-9550
- NPI assigned
- Apr 23, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 000463 | PR | |
| Speech-Language Pathologist | 235Z00000X | 109943 | TX | Primary |
Addresses
Primary practice location
2192 Raines CT
Euless, TX 76039-4259
Mailing address
2192 Raines CT
Euless, TX 76039-4259
Phone (787) 479-9550
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 337937201 | Medicaid | TX | |
| 8ES497 | Other | TX | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000463 | PR | MD | Chiropractor |
| 109943 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425859200000",
"number": "1336406776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2192 RAINES CT",
"city": "EULESS",
"state": "TX",
"postal_code": "760394259",
"telephone_number": "787-479-9550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2192 RAINES CT",
"city": "EULESS",
"state": "TX",
"postal_code": "760394259",
"telephone_number": "787-479-9550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LA CRUZ",
"first_name": "SUSAN",
"name_prefix": "Ms.",
"credential": "MS CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-23",
"last_updated": "2015-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PR",
"license": "000463",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "109943",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "337937201",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8ES497",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Euless, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.