NPIMap

Organization Active NPI

Texas Elite Therapy Team LLC

  • Speech-Language Pathologist
  • Hallettsville, TX
National Provider Identifier
1356038947
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 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
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Katie Broom, M.A. CCC-SLPNPI 1003307547
Title
Speech Language Pathologist
Phone
(361) 772-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

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

1101 E Airline Rd
Victoria, TX 77901-4000
Phone (361) 210-7366

Other practice location 2

711 N Avenue D
Shiner, TX 77984-5210
Phone (361) 210-7366

Other practice location 3

109 Shult Dr
Columbus, TX 78934-3009
Phone (361) 210-7366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory

Locations

200 W 4th St
Hallettsville, TX 77964
Phone (361) 210-7366

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1356038947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 166",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779640166",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S JUDY ST",
            "city": "HALLETTSVILLE",
            "state": "TX",
            "postal_code": "779643223",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 E Airline Rd",
            "address_purpose": "LOCATION",
            "city": "Victoria",
            "state": "TX",
            "postal_code": "779014000",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "711 N Avenue D",
            "address_purpose": "LOCATION",
            "city": "Shiner",
            "state": "TX",
            "postal_code": "779845210",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 Shult Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "TX",
            "postal_code": "789343009",
            "country_code": "US",
            "telephone_number": "361-210-7366",
            "fax_number": "361-799-5001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TEXAS ELITE THERAPY TEAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "BROOM",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "361-772-2401",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallettsville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.