Texas Elite Therapy Team LLC
Organization Active NPI Speech-Language Pathologist · Hallettsville, TX
NPI 1356038947 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1356038947
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- Legal business name
- TEXAS ELITE THERAPY TEAM LLC
- Practice address
- 107 S Judy St
Hallettsville, TX 77964-3223 - Phone
- (361) 210-7366
- Fax
- (361) 799-5001
- NPI assigned
- Apr 24, 2023
- Organization subpart
- No
Authorized official
- Name
- Katie Broom, M.A. CCC-SLP
- Title
- Speech Language Pathologist
- Phone
- (361) 772-2401
Practitioners 6
-
Katie Broom, M.A. CCC-SLP
-
Lauren Pasak, MA CCC-SLP
-
Haylie Cernoch, M.S. CCC- SLP
-
Victoria Hoskins, M.S., CCC- SLP
-
Tristan Meisetschleager, M.S. CCC - SLP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230627002976 | TX | Part B Supplier - Clinic/Group Practice | 2466810171 |
Receives reassigned benefits from 2 practitioners Practice locations: Victoria, TX; Shiner, TX; Columbus, TX; Hallettsville, TX |
National Provider Directory
Locations
109 Shult Dr
Columbus, TX 78934
Phone (979) 732-2361
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist |
235Z00000X | Yes |
Addresses
Primary practice location
107 S Judy St
Hallettsville, TX 77964-3223
Mailing address
PO Box 166
Hallettsville, TX 77964-0166
Phone (361) 210-7366
Other practice location 1
711 N Avenue D
Shiner, TX 77984-5210
Phone (361) 210-7366
Other practice location 2
1101 E Airline Rd
Victoria, TX 77901-4000
Phone (361) 210-7366
Other practice location 3
109 Shult Dr
Columbus, TX 78934-3009
Phone (361) 210-7366
Other providers in Hallettsville, TX
- Chelsea Smith
- Victoria Stang
- Ronnie Arlyn Starling
- Carol Ann Steffek
- Kari Stephens
- Carleton K Thompson
- Joshua Eric Torres
- Victoria Vision Center LLC
- Shea Nicole Vogel
- Lamont Vuong
All providers in Hallettsville, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.