Individual provider Active NPI

Jennifer Blan, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Houston, TX
National Provider Identifier
1386984912
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
18037 Issued in TX
Practice address
14703 Eagle Vista Dr
Houston, TX 77077-5394
Phone
(281) 249-7103
NPI assigned
Feb 19, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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 18037 TX Primary

Addresses

Primary practice location

14703 Eagle Vista Dr
Houston, TX 77077-5394

Mailing address

14703 Eagle Vista Dr
Houston, TX 77077-5394
Phone (281) 249-7103

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
18037TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1386984912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14703 EAGLE VISTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775394",
            "telephone_number": "281-249-7103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14703 EAGLE VISTA DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770775394",
            "telephone_number": "281-249-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAN",
        "first_name": "JENNIFER",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-02-19",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "18037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.