Individual provider Active NPI

Blanca Estela Cisneros, SLP

  • Speech-Language Pathologist
  • El Paso, TX
National Provider Identifier
1396335840
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
110938 Issued in TX
Practice address
10662 Vista del Sol Dr
El Paso, TX 79935-4520
Phone
(915) 855-9333
Fax
(915) 855-9213
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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 110938 TX Primary

Addresses

Primary practice location

10662 Vista del Sol Dr
El Paso, TX 79935-4520

Mailing address

6611 Boeing Dr
El Paso, TX 79925-1010
Phone (915) 780-6576

Other practice location 1

6611 Boeing Dr
El Paso, TX 79925-1010
Phone (915) 780-6576

Other identifiers 1

IdentifierTypeStateIssuer
110938OtherTXLICENSE

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

State licenses

LicenseStateTypeSpecialty
110938TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Region 19 Education Service Center CurrentSince Jul 7, 2024 Accepting new patients

Locations

6611 Boeing Dr
El Paso, TX 79925
Phone (915) 780-6564

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1396335840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 BOEING DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799251010",
            "telephone_number": "915-780-6576",
            "fax_number": "915-780-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10662 VISTA DEL SOL DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799354520",
            "telephone_number": "915-855-9333",
            "fax_number": "915-855-9213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6611 Boeing Dr",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799251010",
            "country_code": "US",
            "telephone_number": "915-780-6576",
            "fax_number": "915-780-5303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CISNEROS",
        "first_name": "BLANCA",
        "middle_name": "ESTELA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "110938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "110938",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.