Active NPI
Theresa Mata-Pistokache, PH.D.
- Speech-Language Pathologist
- Weslaco, TX
National Provider Identifier
1396129003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 106747
- Practice address
- 709 Angelita Dr
Weslaco, TX 78599-5281 - Phone
- (956) 854-4325
- Fax
- (956) 854-4338
- NPI assigned
- Jul 13, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 106747 | TX | Primary |
Addresses
Primary practice location
709 Angelita Dr
Weslaco, TX 78599-5281
Mailing address
305 NE Loop 820
Business Tower 1, Suite 200
Hurst, TX 76053-7209
Phone (817) 292-8787
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106747 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1396129003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 NE LOOP 820",
"address_2": "BUSINESS TOWER 1, SUITE 200",
"city": "HURST",
"state": "TX",
"postal_code": "760537209",
"telephone_number": "817-292-8787",
"fax_number": "817-789-6849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 ANGELITA DR",
"city": "WESLACO",
"state": "TX",
"postal_code": "785995281",
"telephone_number": "956-854-4325",
"fax_number": "956-854-4338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATA-PISTOKACHE",
"first_name": "THERESA",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "106747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weslaco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.