Mally Bomkamp, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1000414 Issued in TX

Practice address

1231 Greenway Dr Ste 100
Irving, TX 75038-2525

Phone

(972) 871-1800

NPI assigned

Mar 19, 2018

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• FST, LLC

  dba First Steps Pediatric Therapy Specialists

  • Home Health Agency
  • Irving, TX
  • NPI 1952602476
  NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1366946014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 E TRIPP RD",
            "city": "SUNNYVALE",
            "state": "TX",
            "postal_code": "751829588",
            "telephone_number": "214-505-4498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 GREENWAY DR STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382525",
            "telephone_number": "972-871-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Jupiter Rd",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750427108",
            "country_code": "US",
            "telephone_number": "972-487-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOMKAMP",
        "first_name": "MALLY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "1000414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edgar Howard Boles III, CRNA
• Kathryn A Bolt
• David Dmitry Boltan, M.D.
• Lindsay Elizabeth Boltan, M.D.
• Kecia Bolton
• Srilakshmi Bommisetty
• Niloofar Bonakdar Hashemi, DDS
• Parisa Bond, DNAP, CRNA
• David C Bonfessuto, RPH, DC, RN, NP-C
• Rajshree Namdeorao Bongale, M.D.

• Speech-Language Pathologist in Irving, TX
• Providers in Irving, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 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.