Individual provider Active NPI

Adriana Eastman, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Haltom City, TX
National Provider Identifier
1336564087
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
108107 Issued in TX
Practice address
3145 Denton Hwy
Haltom City, TX 76117-3710
Phone
(817) 831-1078
Fax
(817) 831-1730
NPI assigned
Mar 4, 2014
Last updated
Dec 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 108107 TX Primary

Addresses

Primary practice location

3145 Denton Hwy
Haltom City, TX 76117-3710

Mailing address

4601 Medical Center Dr Ste a&C-1
McKinney, TX 75069-1771
Phone (469) 850-2909

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

LicenseStateTypeSpecialty
108107TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Myo Fun Speech Plus Speech-Language Pathologist CurrentSince Dec 10, 2023 Accepting new patients
Epic Pediatric Therapy, LP. Past Accepting new patients

Locations

4601 Medical Center Dr
Ste AC1
McKinney, TX 75069
Phone (469) 850-2909

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1336564087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MEDICAL CENTER DR STE A&C-1",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750691771",
            "telephone_number": "469-850-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 DENTON HWY",
            "city": "HALTOM CITY",
            "state": "TX",
            "postal_code": "761173710",
            "telephone_number": "817-831-1078",
            "fax_number": "817-831-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTMAN",
        "first_name": "ADRIANA",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-04",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "108107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haltom City, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2022; 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.